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NPI Code Detail

MEDICARE: VALLEY COMPREHENSIVE COMMUNITY MENTAL HEALTH CENTER, INC.

MEDICARE: VALLEY COMPREHENSIVE COMMUNITY MENTAL HEALTH CENTER, 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
1101YM0800XMental Health Counselor21WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861476350
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY COMPREHENSIVE COMMUNITY MENTAL HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : 301 SCOTT AVE
Second Line :
City : MORGANTOWN
State : WV
Zip : 26508-8804
Country : US
Telephone Number : 304-296-1731
Fax Number : 304-225-2288
Provider Business Practice Location Address
First Line : 301 SCOTT AVE
Second Line :
City : MORGANTOWN
State : WV
Zip : 26508-8804
Country : US
Telephone Number : 304-296-1731
Fax Number : 304-225-2288
Authorized Official
Title or Position : CEO
Name : CHERYL L PERONE
Credential :
Telephone Number : 304-296-1731
Provider Enumeration Date : 11/30/2005
Last Update Date : 04/11/2014

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Directions to “VALLEY COMPREHENSIVE COMMUNITY MENTAL HEALTH CENTER, INC. ” Practice Location

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