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General NPI Number Information
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NPI Number | 1366033615
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Entity Type | Organization
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Legal Business Name | KEEP YOUR FAITH CORPORATION INCORPORATED
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Dates
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Enumeration Date | 01/29/2021
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 1313 QUARRIER ST
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City | CHARLESTON
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State | WV
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Zip | 25301-6002
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Country | US
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Telephone | 304-881-7736
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Fax |
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Provider Business Mailing Address
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Address Line | 1313 QUARRIER ST
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City | CHARLESTON
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State | WV
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Zip | 25301-6002
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Country | US
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Telephone | 304-881-7736
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Fax |
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Authorized Official
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Title or Position | STATEWIDE CLINICAL DIRECTOR
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Name | ALECIA ALLEN
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Credential | LPC
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Telephone | 304-881-7736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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