| Home Base Inc Mdgrp | |
|
5 1/2 W Main St Buckhannon WV 26201-2235 | |
| (304) 472-8707 | |
| (304) 472-8978 |
| Full Name | Home Base Inc Mdgrp |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5 1/2 W Main St, Buckhannon, West Virginia |
| Authorized Official Name and Position | Damon C. Cater (CEO) |
| Authorized Official Contact | 3044728707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Home Base Inc Mdgrp Po Box 2024 Buckhannon WV 26201-7024 Ph: (304) 472-8707 | Home Base Inc Mdgrp 5 1/2 W Main St Buckhannon WV 26201-2235 Ph: (304) 472-8707 |
| NPI Number | 1154596757 |
|---|---|
| Provider Enumeration Date | 04/24/2008 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154596757 | NPI | - | NPPES |
| 3810007185 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 135 (West Virginia) | Primary |
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