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General NPI Number Information
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NPI Number | 1699571372
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Entity Type | Organization
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Legal Business Name | HEALTHPATH MEDICAL & PSYCHIATRIC CARE LLC
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Dates
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Enumeration Date | 02/22/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 110 ASSOCIATION DR
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City | CHARLESTON
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State | WV
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Zip | 25311-1217
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Country | US
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Telephone | 304-952-3696
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Fax |
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Provider Business Mailing Address
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Address Line | 110 ASSOCIATION DR
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City | CHARLESTON
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State | WV
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Zip | 25311-1217
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Country | US
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Telephone | 304-952-3696
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LORETTA ANN BOSTIC
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Credential | DNP, APRN
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Telephone | 304-208-0707
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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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