Provider Demographics
NPI:1366033615
Name:KEEP YOUR FAITH CORPORATION INCORPORATED
Entity Type:Organization
Organization Name:KEEP YOUR FAITH CORPORATION INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATEWIDE CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:304-881-7736
Mailing Address - Street 1:1313 QUARRIER ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-6002
Mailing Address - Country:US
Mailing Address - Phone:304-881-7736
Mailing Address - Fax:
Practice Address - Street 1:1313 QUARRIER ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-6002
Practice Address - Country:US
Practice Address - Phone:304-881-7736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEEP YOUR FAITH CORPORATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-29
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty