MEDICARE: TEN UP MINISTRIES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1760006407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEN UP MINISTRIES, INC

Provider Business Mailing Address
First Line	:	51 OLDE MAIN PLZ
Second Line	:
City	:	SAINT ALBANS
State	:	WV
Zip	:	25177-2752
Country	:	US
Telephone Number	:	304-419-7252
Fax Number	:	855-888-9316

Provider Business Practice Location Address
First Line	:	335 4TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-1223
Country	:	US
Telephone Number	:	304-419-7252
Fax Number	:	855-888-9316

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	WESLEY WOOD
Credential	:
Telephone Number	:	304-766-0060

Provider Enumeration Date	:	05/28/2020
Last Update Date	:	05/28/2020

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