Healthcare Provider Details

I. General information

NPI: 1245404359
Provider Name (Legal Business Name): VALLEY HEALTH CARE SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2008
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 LEONARD AVE
FAIRMONT WV
26554-3843
US

IV. Provider business mailing address

448 LEONARD AVE
FAIRMONT WV
26554-3843
US

V. Phone/Fax

Practice location:
  • Phone: 304-366-7174
  • Fax: 304-366-7419
Mailing address:
  • Phone: 304-366-7174
  • Fax: 304-366-7419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberNA
License Number StateWV

VIII. Authorized Official

Name: MS. DENISE MICHELLE HIGGINS
Title or Position: ADOLESCENT SUBSTANCE AB. THERAPIST
Credential: MS, CRC
Phone: 304-366-7174