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General NPI Number Information
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NPI Number | 1629290127
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Entity Type | Organization
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Legal Business Name | MARTINSBURG INSTITUTE INC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 223 EAGLE SCHOOL RD
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City | MARTINSBURG
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State | WV
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Zip | 25404-3367
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Country | US
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Telephone | 304-263-1101
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Fax | 304-263-0031
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Provider Business Mailing Address
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Address Line | 223 EAGLE SCHOOL RD
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City | MARTINSBURG
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State | WV
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Zip | 25404-3367
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Country | US
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Telephone | 304-263-1101
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Fax | 304-263-0031
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | NEAL BERCH
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Credential | BS
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Telephone | 304-263-1101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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