Healthcare Provider Details

I. General information

NPI: 1639006976
Provider Name (Legal Business Name): AXISPOINT HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 10TH ST
HUNTINGTON WV
25701-2809
US

IV. Provider business mailing address

803 10TH ST
HUNTINGTON WV
25701-2809
US

V. Phone/Fax

Practice location:
  • Phone: 304-369-1660
  • Fax: 304-398-6434
Mailing address:
  • Phone: 304-369-1660
  • Fax: 304-398-6434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: RANDELL WAGGONER
Title or Position: CEO/PRESIDENT
Credential: LPN
Phone: 304-360-4316