# VERSACARE MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962178269
- **Authorized official:** AMANDA E MCCARTY MS, MBA, MHA (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (304) 615-9925

## Contact information

- **Practice address:** 1260A GREENBRIER ST, CHARLESTON, WV 25311-1002
- **Practice address phone:** (304) 915-2500
- **Mailing address:** 115 TROTTERS LN, CHARLESTON, WV 25312-6770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 08/18/2021
- **Last updated:** 08/30/2021