Organization
YELLOW BRICK ROAD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY JO WILSON (EXECUTIVE DIRECTOR)
(304) 551-1279
Entity
Organization
Contact information
Practice address
1510 4TH ST, MOUNDSVILLE, WV 26041-1733
(304) 551-1279
Mailing address
1510 4TH ST, MOUNDSVILLE, WV 26041-1733
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/14/2008
Last updated
07/14/2008
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