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Organization
SPOTTED OWL HEALTHCARE ORGANIZATION
Active
Organization
SPOTTED OWL HEALTHCARE ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ORLANDO YUSEF CRAIGHEAD (PROGRAM DIRECTOR)
(304) 610-5732
Entity
Organization
Contact information
Practice address
807 ELVIRA RD, DUNBAR, WV 25064-1001
(304) 610-5732
Mailing address
2635 RIVERSIDE DR, SAINT ALBANS, WV 25177-3312
(304) 610-5732
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
174H00000X
Health Educator
—
NULL
174H00000X
Health Educator
—
—
251B00000X
Case Management Agency
—
NULL
251E00000X
Home Health Agency
—
NULL
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
252Y00000X
Early Intervention Provider Agency
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
NULL
302R00000X
Health Maintenance Organization
—
NULL
Other
Enumeration date
10/25/2019
Last updated
04/08/2024
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