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General NPI Number Information
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NPI Number | 1457838054
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Entity Type | Organization
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Legal Business Name | TRI-STATE ADDICTION RECOVERY RESOURCES
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 537 WASHINGTON AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701-1039
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Country | US
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Telephone | 304-416-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4100
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-4100
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Country | US
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Telephone | 304-955-6200
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Fax | 304-399-2526
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Authorized Official
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Title or Position | OWNER
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Name | HELEN CRUTCHER
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Credential |
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Telephone | 304-416-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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