Healthcare Provider Details

I. General information

NPI: 1558971341
Provider Name (Legal Business Name): PARKERSBURG ADDICTION RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 EMERSON AVE
PARKERSBURG WV
26104-2519
US

IV. Provider business mailing address

2910 EMERSON AVE
PARKERSBURG WV
26104-2519
US

V. Phone/Fax

Practice location:
  • Phone: 304-239-5355
  • Fax: 304-699-1923
Mailing address:
  • Phone: 740-856-1084
  • Fax: 304-699-1923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MERANDA S MURPHY
Title or Position: CEO
Credential:
Phone: 740-856-1084