Provider Demographics
NPI:1164176004
Name:CHEAT ROAD PROJECT ASSOCIATES LLC
Entity Type:Organization
Organization Name:CHEAT ROAD PROJECT ASSOCIATES LLC
Other - Org Name:WISE PATH RECOVERY CENTERS-MORGANTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-216-3545
Mailing Address - Street 1:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:DELLSLOW
Mailing Address - State:WV
Mailing Address - Zip Code:26531-0269
Mailing Address - Country:US
Mailing Address - Phone:304-216-3545
Mailing Address - Fax:
Practice Address - Street 1:2195 CHEAT RD STE 100
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-0022
Practice Address - Country:US
Practice Address - Phone:304-503-3448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health