Organization
MBH PHYSICIAN GROUP -WV PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA PERSILY (CEO)
(304) 348-1421
Entity
Organization
Contact information
Practice address
1418 MACCORKLE AVE SW, CHARLESTON, WV 25303-1342
(304) 925-6914
Mailing address
1014 CEDARWOOD CIR, FLORENCE, SC 29501-8497
(843) 687-4329
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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