Organization
COMMUNITY GROWTH BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ARTENTUS LASHA WILSON (OWNER)
(704) 361-1999
Entity
Organization
Contact information
Practice address
602 VIRGINIA ST E STE 100, CHARLESTON, WV 25301-2154
(704) 361-1999
Mailing address
602 VIRGINIA ST E STE 100, CHARLESTON, WV 25301-2154
(704) 361-1999
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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