Organization
ST. JOSEPH RECOVERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA J MEADOWS (CEO)
(304) 916-1881
Entity
Organization
Contact information
Practice address
1824 MURDOCH AVE BLDG C, PARKERSBURG, WV 26101-3230
(304) 916-1881
Mailing address
1824 MURDOCH AVE BLDG C, PARKERSBURG, WV 26101-3230
(304) 916-1881
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174021406
—
WV
Enumeration date
02/01/2018
Last updated
02/12/2020
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