Provider Demographics
NPI:1568889525
Name:WESTBROOK HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:WESTBROOK HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPPETT
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:304-485-1721
Mailing Address - Street 1:2121 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3803
Mailing Address - Country:US
Mailing Address - Phone:304-485-1721
Mailing Address - Fax:304-424-9424
Practice Address - Street 1:2121 7TH STREET
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3803
Practice Address - Country:US
Practice Address - Phone:304-485-1721
Practice Address - Fax:304-424-9424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23251S00000X
WV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0005499003Medicaid
WV9150901Medicare UPIN