GREEN ACRES REGIONAL CENTER INC NPI 1245398130

NPI Information

NPI: 1245398130
Provider Name: GREEN ACRES REGIONAL CENTER INC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
7830 OHIO RIVER ROAD
LESAGE, WV
ZIP 25537
Phone: (304) 762-2522
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GREEN ACRES REGIONAL CENTER INC is a mental health (including community mental health center) clinic center in Lesage, WV. GREEN ACRES REGIONAL CENTER INC NPI is 1245398130. The provider is registered as an organization entity type.

The provider's business location address is:

7830 OHIO RIVER ROAD
LESAGE, WV
ZIP 25537
Phone: (304) 762-2522
Fax: (304) 762-2862

The provider's authorized official is Emma Sue Smith .
The authorized official title is Executive Director and has the following contact phone number (304) 762-2522.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0005317001	MEDICAID	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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