Healthcare Provider Details

I. General information

NPI: 1861492605
Provider Name (Legal Business Name): THE LENFEST CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 12/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 3RD ST
ELKINS WV
26241-3831
US

IV. Provider business mailing address

100 3RD ST
ELKINS WV
26241-3831
US

V. Phone/Fax

Practice location:
  • Phone: 304-636-1811
  • Fax: 304-636-3718
Mailing address:
  • Phone: 304-636-1811
  • Fax: 304-636-3718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number108
License Number StateWV

VIII. Authorized Official

Name: DR. ALLAN L LAVOIE
Title or Position: PRESIDENT
Credential: PHD
Phone: 304-636-1811