Organization
STRONG THROUGH OUR PLAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET PETERWORTH (BOARD OF DIRECTORS, CHAIRPERSON)
(304) 393-1481
Entity
Organization
Contact information
Practice address
202 LARRY JOE HARLESS DR., GILBERT, WV 25621-1385
(304) 664-3986
(304) 664-2997
Mailing address
P.O. BOX 1385, 202 LARRY JOE HARLESS DR., GILBERT, WV 25621-1385
(304) 664-3986
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/04/2011
Last updated
02/04/2011
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