Mountaineer Life Enrichment Center, Llc | |
1522 Bunner Ridge Rd Fairmont WV 26554-5079 | |
(304) 373-4678 | |
Not Available |
Full Name | Mountaineer Life Enrichment Center, Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 1522 Bunner Ridge Rd, Fairmont, West Virginia |
Authorized Official Name and Position | Charles Sears (CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 3043734678 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mountaineer Life Enrichment Center, Llc 1522 Bunner Ridge Rd Fairmont WV 26554-5079 Ph: (304) 373-4678 | Mountaineer Life Enrichment Center, Llc 1522 Bunner Ridge Rd Fairmont WV 26554-5079 Ph: (304) 373-4678 |
NPI Number | 1275232043 |
---|---|
Provider Enumeration Date | 03/01/2023 |
Last Update Date | 03/01/2023 |
Certification Date | 03/01/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275232043 | NPI | - | NPPES |
00000 | Other | SELF PAY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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