Provider Demographics
NPI:1033411905
Name:DAYMARK INC.
Entity Type:Organization
Organization Name:DAYMARK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR FO PROGRAMS
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:PLEASANT
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MAC, LSW
Authorized Official - Phone:304-340-3670
Mailing Address - Street 1:1592 WASHINGTON ST E STE 2
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-2509
Mailing Address - Country:US
Mailing Address - Phone:304-340-3670
Mailing Address - Fax:304-342-0333
Practice Address - Street 1:1583 LEE ST E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-2403
Practice Address - Country:US
Practice Address - Phone:304-340-3670
Practice Address - Fax:304-342-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV08GRR049320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness