Organization
HOME BASE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAMON C CATER (CEO)
(304) 678-4159
Entity
Organization
Contact information
Practice address
713 BIGLEY AVE, CHARLESTON, WV 25302-3356
(304) 746-2918
(304) 746-2919
Mailing address
713 BIGLEY AVE., CHARLESTON, WV 25302
(304) 746-2918
(304) 746-2919
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
135
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9435000000
—
WV
05
—
9435000001
—
WV
Enumeration date
04/21/2015
Last updated
04/21/2015
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