Organization
UHA-BEHAVIORAL MED AND PSYCH LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA M HENSON (CORPORATE SUPERVISOR)
(304) 293-5033
Entity
Organization
Contact information
Practice address
930 CHESTNUT RIDGE RD, MORGANTOWN, WV 26505-2807
(304) 598-4214
(304) 293-6963
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011526000
—
WV
Enumeration date
10/24/2007
Last updated
10/24/2007
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