Healthcare Provider Details

I. General information

NPI: 1588189997
Provider Name (Legal Business Name): PALMS RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 OLIVE ST
HUNTINGTON WV
25705-1520
US

IV. Provider business mailing address

1820 CRESTMONT DR
HUNTINGTON WV
25701-5349
US

V. Phone/Fax

Practice location:
  • Phone: 304-617-0880
  • Fax:
Mailing address:
  • Phone: 304-617-0880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateWV

VIII. Authorized Official

Name: MISS TRESHA L BURNS
Title or Position: CO-OWNER
Credential:
Phone: 304-617-0880