Healthcare Provider Details

I. General information

NPI: 1518239839
Provider Name (Legal Business Name): NATURAL RESILIENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 12/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 COOMBS FARM ROAD SUITE 106B
MORGANTOWN WV
26508-1126
US

IV. Provider business mailing address

2000 COOMBS FARM ROAD SUITE 106B
MORGANTOWN WV
26508-1126
US

V. Phone/Fax

Practice location:
  • Phone: 304-381-2211
  • Fax: 304-206-3121
Mailing address:
  • Phone: 304-381-2211
  • Fax: 304-206-3121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number1998
License Number StateWV

VIII. Authorized Official

Name: MRS. JOANN MARIE FREY
Title or Position: OWNER
Credential:
Phone: 724-208-2833