| Pch Behavioral Medicine Unit | |
|
122 12th Street Ext Princeton WV 24740-2352 | |
| (304) 487-7000 | |
| (304) 487-7370 |
| Full Name | Pch Behavioral Medicine Unit |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 122 12th Street Ext, Princeton, West Virginia |
| Authorized Official Name and Position | Diane Lynn Spencer (VP OF FINANCE/CFO) |
| Authorized Official Contact | 3044877505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pch Behavioral Medicine Unit 122 12th Street Extension Princeton WV 24740-2352 Ph: (304) 487-7000 | Pch Behavioral Medicine Unit 122 12th Street Ext Princeton WV 24740-2352 Ph: (304) 487-7000 |
| NPI Number | 1235311044 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235311044 | NPI | - | NPPES |
| 0001111002 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 104 (West Virginia) | Primary |
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