Healthcare Provider Details

I. General information

NPI: 1467669226
Provider Name (Legal Business Name): RADICAL REHAB SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 9TH ST
HUNTINGTON WV
25701-1436
US

IV. Provider business mailing address

PO BOX 6456
HUNTINGTON WV
25772-6456
US

V. Phone/Fax

Practice location:
  • Phone: 304-781-2510
  • Fax: 304-525-3311
Mailing address:
  • Phone: 304-781-2510
  • Fax: 304-525-3311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES FREDERICK PHIFER
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 304-781-2510