Devaraj Behavioral Healthcare Pllc | |
1109 Jefferson Rd Ste C South Charleston WV 25309-8815 | |
(877) 338-2725 | |
(304) 715-3537 |
Full Name | Devaraj Behavioral Healthcare Pllc |
---|---|
Speciality | Community/behavioral Health |
Location | 1109 Jefferson Rd Ste C, South Charleston, West Virginia |
Authorized Official Name and Position | Jacob M Bounds (CLINICAL DIRECTOR) |
Authorized Official Contact | 8773382725 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Devaraj Behavioral Healthcare Pllc 1109 Jefferson Rd Ste C South Charleston WV 25309-8815 Ph: (877) 338-2725 | Devaraj Behavioral Healthcare Pllc 1109 Jefferson Rd Ste C South Charleston WV 25309-8815 Ph: (877) 338-2725 |
NPI Number | 1356980916 |
---|---|
Provider Enumeration Date | 12/31/2019 |
Last Update Date | 01/05/2022 |
Certification Date | 01/05/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356980916 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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Devaraj Behavioral Healthcare Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1109 Jefferson Rd Ste C, South Charleston, WV 25309 Phone: 877-338-2725 Fax: 304-715-3537 | |
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