Healthcare Provider Details

I. General information

NPI: 1205428257
Provider Name (Legal Business Name): ANCHOR PROJECT SUN VALLEY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5241 SUN VALLEY DR
CROSS LANES WV
25313-1235
US

IV. Provider business mailing address

1213 OHIO AVE
DUNBAR WV
25064-3019
US

V. Phone/Fax

Practice location:
  • Phone: 304-419-7252
  • Fax: 855-888-9316
Mailing address:
  • Phone: 304-419-7252
  • Fax: 855-888-9316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: WESLEY WOOD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-419-7252