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467 Main St Ste 3 Madison WV 25130-2200 | |
(304) 369-7876 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 467 Main St Ste 3, Madison, West Virginia |
Authorized Official Name and Position | Virgil Underwood (CEO) |
Authorized Official Contact | 3043691230 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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701 Madison Ave Madison WV 25130-1699 Ph: (304) 369-1230 | 467 Main St Ste 3 Madison WV 25130-2200 Ph: (304) 369-7876 |
NPI Number | 1184361347 |
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Provider Enumeration Date | 05/18/2022 |
Last Update Date | 07/28/2022 |
Certification Date | 07/28/2022 |
Identifier | Type | State | Issuer |
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1184361347 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |