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Organization

HOME BASE INC.

Active
Other names
Home Base Upshur County Group Home
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAMON C. CATER (CEO)
(304) 472-6826
Entity
Organization

Contact information

Practice address
1362 MOUNTAIN RIDGE RD, BUCKHANNON, WV 26201-5117
(304) 473-6826
(304) 472-8978
Mailing address
713 BIGLEY AVE, CHARLESTON, WV 25302-3356
(304) 746-2918
(304) 472-8978

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
135
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9435000000
WV
Enumeration date
07/20/2007
Last updated
07/08/2024
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