Healthcare Provider Details

I. General information

NPI: 1083804611
Provider Name (Legal Business Name): APPALACHIAN COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 WALNUT ST
PARSONS WV
26287-1054
US

IV. Provider business mailing address

601 WALNUT ST
PARSONS WV
26287-1054
US

V. Phone/Fax

Practice location:
  • Phone: 304-478-2764
  • Fax:
Mailing address:
  • Phone: 304-478-2764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD KILEY
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 304-636-3232