Healthcare Provider Details

I. General information

NPI: 1952883019
Provider Name (Legal Business Name): ADVOCATE HOUSE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 WASHINGTON AVE
HUNTINGTON WV
25701-1056
US

IV. Provider business mailing address

PO BOX 9083
HUNTINGTON WV
25704-0083
US

V. Phone/Fax

Practice location:
  • Phone: 740-894-1403
  • Fax: 740-451-0509
Mailing address:
  • Phone: 740-894-1403
  • Fax: 740-451-0509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number9A592
License Number StateWV

VIII. Authorized Official

Name: MS. JULIA ANN BORDERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-634-7052