| Kanawha Valley Center Inc | |
|
200 Bradford Street Charleston WV 25301-5301 | |
| (800) 835-5277 | |
| (304) 347-9820 |
| Full Name | Kanawha Valley Center Inc |
|---|---|
| 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 |
|---|---|
| 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 | 1386851509 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386851509 | NPI | - | NPPES |
| 5200000000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (West Virginia) | Primary |
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