Organization
POTOMAC HIGHLANDS GUILD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK S. RAINES MD (PSYCHIATRIST)
(304) 257-1155
Entity
Organization
Contact information
Practice address
6 PARK ST, PETERSBURG, WV 26847-1765
(304) 257-1155
(304) 257-1945
Mailing address
6 PARK ST, PETERSBURG, WV 26847-1765
(304) 257-1155
(304) 257-1945
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
14000
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005473002
—
WV
Enumeration date
09/10/2007
Last updated
09/10/2007
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