Healthcare Provider Details

I. General information

NPI: 1609362391
Provider Name (Legal Business Name): TEN UP MINISTRIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 MACCORKLE AVE STE 201
SAINT ALBANS WV
25177-2074
US

IV. Provider business mailing address

2333 MACCORKLE AVE STE 203
SAINT ALBANS WV
25177-2074
US

V. Phone/Fax

Practice location:
  • Phone: 304-419-7252
  • Fax: 855-888-9316
Mailing address:
  • Phone: 304-766-0060
  • Fax: 855-888-9316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: WESLEY WOOD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-766-0060