Provider Demographics
NPI:1245404359
Name:VALLEY HEALTH CARE SYSTEMS
Entity Type:Organization
Organization Name:VALLEY HEALTH CARE SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADOLESCENT SUBSTANCE AB. THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CRC
Authorized Official - Phone:304-366-7174
Mailing Address - Street 1:448 LEONARD AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-3843
Mailing Address - Country:US
Mailing Address - Phone:304-366-7174
Mailing Address - Fax:304-366-7419
Practice Address - Street 1:448 LEONARD AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-3843
Practice Address - Country:US
Practice Address - Phone:304-366-7174
Practice Address - Fax:304-366-7419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVNA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health