Kanawha Valley Center Inc | |
200 Bradford Street Charleston WV 25301-5301 | |
(800) 835-5277 | |
(304) 347-9820 |
Full Name | Kanawha Valley Center Inc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 200 Bradford Street, Charleston, West Virginia |
Authorized Official Name and Position | Kristi Renea Ferrell (DIRECTOR OF ADMINISTRATION AND HUMA) |
Authorized Official Contact | 3043479818 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Kanawha Valley Center Inc 200 Bradford Street Charleston WV 25301-5301 Ph: (800) 835-5277 | Kanawha Valley Center Inc 200 Bradford Street Charleston WV 25301-5301 Ph: (800) 835-5277 |
NPI Number | 1164639373 |
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Provider Enumeration Date | 05/17/2007 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164639373 | NPI | - | NPPES |
5200000001 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (West Virginia) | Primary |
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