JACKSON COUNTY DEVELOPMENTAL CENTER, INC (NPI# 1528381746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528381746 |
| Entity Type | Organization |
| Organization Name | JACKSON COUNTY DEVELOPMENTAL CENTER, INC |
| Other Organization Name | JCDC |
| Practice Address |
270 Jack Burlingame Dr Millwood WV 25262-8576 |
| Practice Telephone | 3042739311 |
| Practice Fax Number | 3042735131 |
| Mailing Telephone | 3042739311 |
| Mailing Fax Number | 3042735131 |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2010-03-02 |
| Authorized Official Name | MR. CRAIG ALAN GREENING (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3042739311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | 406 | WV | Agencies |
| N | 253Z00000X | In Home Supportive Care | 406 | WV | Agencies |
| Y | 251C00000X | Day Training, Developmentally Disabled Services | 406 | WV | Agencies |
| Other Name | Type Code |
|---|---|
| JCDC | Doing Business As Name - Organization |
| Street Address |
270 JACK BURLINGAME DR |
| City | MILLWOOD |
| State | WV |
| Zip Code | 25262-8576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041529 | Jennifer Lyn Greening | Technician | 270 Jack Burlingame Dr, Millwood, WV 25262-8576 | 2020-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336192269 | J. Derek Hollingsworth | Family Medicine | 6775 Point Pleasant Rd, Millwood, WV 25262-8100 | 2006-05-19 |
| 1023553443 | Peggy Mccormick | Social Worker | 6775 Point Pleasant Rd, Millwood, WV 25262-8100 | 2016-12-20 |
| 1699127829 | West Virginia Rehabilitation Centers | Substance Abuse Rehabilitation Facility | 6775 Point Pleasant Rd, Millwood, WV 25262-8100 | 2016-07-12 |
| 1396103578 | Anthony Bell | Social Worker | 6775 Point Pleasant Rd, Millwood, WV 25262-8100 | 2016-02-03 |
| 1821462789 | Natalie Mcneely | Psychologist | 6775 Point Pleasant Rd, Millwood, WV 25262-8100 | 2015-11-16 |
| 1861432593 | Louis A Yancich | Personal Emergency Response Attendant | 6775 Point Pleasant Rd, Millwood, WV 25262-8100 | 2006-06-08 |
| 1316552805 | Debra E Casto | Technician | 840 Woodland Dr, Millwood, WV 25262-8574 | 2020-09-10 |
| 1477169134 | Gary Hoskins | Technician | 284 Marties Dr, Millwood, WV 25262-8584 | 2020-09-18 |
| 1568920700 | Alexis Raelle Price | Specialist/Technologist, Other | 2240 Sugar Run Rd, Millwood, WV 25262-8614 | 2019-03-06 |
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083171078 | Premium Martial Arts Wv LLC | Day Training, Developmentally Disabled Services | 963 Dunbar Village Plz, Dunbar, WV 25064-3137 | 2019-02-26 |
| 1396255261 | Go Journey Journal, Inc. | Day Training, Developmentally Disabled Services | 11738 Maccorkle Ave, Charleston, WV 25315-1035 | 2017-10-05 |
| 1902205214 | Family Options Providers Inc. | Day Training, Developmentally Disabled Services | 550 N Eisenhower Dr Ste A, Beckley, WV 25801-3146 | 2014-08-22 |
| 1790199487 | County of Boone - Board of Health | Day Training, Developmentally Disabled Services | 213 Kenmore Dr, Danville, WV 25053-6890 | 2014-06-20 |
| 1598911638 | Preston County Sheltered Workship, Inc | Day Training, Developmentally Disabled Services | Rt 92 S Jennmar Road, Reedsville, WV 26547 | 2008-08-08 |
| 1235392556 | Vocational Services, Inc. | Day Training, Developmentally Disabled Services | 2178 Big Sandy Road, Amma, WV 25005 | 2008-07-07 |
| 1346401734 | Sheltered Workshop of Nicholas County | Day Training, Developmentally Disabled Services | 16810 Webster Rd., Po Drawer 730, Craigsville, WV 26205-0730 | 2008-06-19 |
| 1871761312 | Job Squad, Inc. | Day Training, Developmentally Disabled Services | 102 Second Street, Bridgeport, WV 26330 | 2008-02-19 |
| 1649457367 | Buckhannon-upshur Work Adjustment Center,inc. | Day Training, Developmentally Disabled Services | Rr 2 Box 62, Buckhannon, WV 26201-9503 | 2008-01-24 |
| 1548470412 | Global Access LLC | Day Training, Developmentally Disabled Services | 25 Estill Dr, Charleston, WV 25314-1523 | 2007-05-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.