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300b 8th St Ste 201 Huntington WV 25701-1413 | |
| (304) 429-1088 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 300b 8th St Ste 201, Huntington, West Virginia |
| Authorized Official Name and Position | Rachel Lynn Blankenship (LEAD CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 3046961636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 390 Huntington WV 25708-0390 Ph: (304) 429-1088 | 300b 8th St Ste 201 Huntington WV 25701-1413 Ph: (304) 429-1088 |
| NPI Number | 1639683725 |
|---|---|
| Provider Enumeration Date | 11/28/2017 |
| Last Update Date | 04/28/2023 |
| Certification Date | 02/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639683725 | NPI | - | NPPES |
| 459 | Other | WV | WV BEHAVIORAL HEALTH LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
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