Provider Demographics
NPI:1043682057
Name:VALLEY ALLIANCE TREATMENT SERVICES
Entity Type:Organization
Organization Name:VALLEY ALLIANCE TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUALAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:304-284-0025
Mailing Address - Street 1:53 DON KNOTTS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-6838
Mailing Address - Country:US
Mailing Address - Phone:304-284-0025
Mailing Address - Fax:304-284-0031
Practice Address - Street 1:53 DON KNOTTS BLVD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-6838
Practice Address - Country:US
Practice Address - Phone:304-284-0025
Practice Address - Fax:304-284-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV09261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone