# MED SURG PHYSICIAN GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elena Behavioral Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083373997
- **Authorized official:** MS. AMBER MOORE (OFFICE MANAGER)
- **Authorized official phone:** (304) 253-3000

## Contact information

- **Practice address:** 379 STANAFORD RD STE 200, BECKLEY, WV 25801-3141
- **Practice address phone:** (304) 253-3000
- **Practice address fax:** (304) 929-2038
- **Mailing address:** 1902 HARPER RD STE ABC, BECKLEY, WV 25801-2642
- **Mailing address phone:** (304) 253-3000
- **Mailing address fax:** (304) 929-2038

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 261QH0100X | Health Service Clinic/Center | — | — | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | — | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | — | — |
| 261QR0800X | Recovery Care Clinic/Center | — | — | — |
| 276400000X | Substance Use Disorder Rehabilitation Hospital Unit | — | — | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | — | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | — | — |
| 3245S0500X | Children's Substance Abuse Rehabilitation Facility | — | — | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | — | — |

## Other

- **Enumeration date:** 12/08/2021
- **Last updated:** 10/12/2023