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Organization
LILYS PLACE FAMILY CENTER
Active
Organization
LILYS PLACE FAMILY CENTER
Active
Parent organization
LILY'S PLACE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LILY'S PLACE INC
Authorized official
MRS. REBECCA DAWN CROWDER MASTER OF ED (EXECUTIVE DIRECTOR)
(304) 523-5459
Entity
Organization
Contact information
Practice address
1235 6TH AVE, HUNTINGTON, WV 25701-2904
(304) 523-5459
(304) 523-8341
Mailing address
PO BOX 2, HUNTINGTON, WV 25706
(304) 523-5459
(304) 523-8341
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3910005949
—
WV
Enumeration date
09/04/2020
Last updated
10/12/2020
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