Provider Demographics
NPI:1225685498
Name:NCGCARE ACQUISITION, LLC
Entity Type:Organization
Organization Name:NCGCARE ACQUISITION, LLC
Other - Org Name:STARLIGHT BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-208-3715
Mailing Address - Street 1:5317 CHERRY LAWN RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2032
Mailing Address - Country:US
Mailing Address - Phone:304-302-2078
Mailing Address - Fax:304-302-7260
Practice Address - Street 1:203 LOWER OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9025
Practice Address - Country:US
Practice Address - Phone:304-302-2078
Practice Address - Fax:304-302-7260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities