Provider Demographics
NPI:1457091852
Name:WESTOVER PROJECT ASSOCIATES LLC
Entity Type:Organization
Organization Name:WESTOVER PROJECT ASSOCIATES LLC
Other - Org Name:WISE PATH RECOVERY CENTER- WESTOVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
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:304-503-3448
Mailing Address - Fax:
Practice Address - Street 1:900 FAIRMONT RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-3847
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:2022-04-01
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility