| Home Base Inc. | |
|
713 Bigley Ave Charleston WV 25302-3356 | |
| (304) 746-2918 | |
| (304) 746-2919 |
| Full Name | Home Base Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 713 Bigley Ave, Charleston, West Virginia |
| Authorized Official Name and Position | Damon Case Cater (OWNER, CEO) |
| Authorized Official Contact | 3047462918 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Home Base Inc. Po Box 20033 Charleston WV 25362-1033 Ph: (304) 746-2918 | Home Base Inc. 713 Bigley Ave Charleston WV 25302-3356 Ph: (304) 746-2918 |
| NPI Number | 1083064695 |
|---|---|
| Provider Enumeration Date | 06/14/2016 |
| Last Update Date | 06/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083064695 | NPI | - | NPPES |
| 440 | Other | WV | WEST VIRGINIA BEHAVIORAL HEALTHCARE LICENSE |
| 9435000000 | Medicaid | WV | |
| 9435000001 | Medicaid | WV |
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