Healthcare Provider Details
I. General information
NPI: 1780707828
Provider Name (Legal Business Name): NORTHWOOD HEALTH SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2007
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17 12TH ST
MCMECHEN WV
26040-1332
US
IV. Provider business mailing address
PO BOX 6400
WHEELING WV
26003-0801
US
V. Phone/Fax
- Phone: 304-234-3520
- Fax: 304-234-3511
- Phone: 304-234-3500
- Fax: 304-234-3511
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 315P00000X |
| Taxonomy | Intellectual Disabilities Intermediate Care Facility |
| License Number | 013 |
| License Number State | WV |
VIII. Authorized Official
Name:
MARK
GAMES
Title or Position: PRESIDENT & CEO
Credential:
Phone: 304-234-3500