Provider Demographics
NPI:1578238143
Name:ANCHORED WELLNESS & RECOVERY
Entity Type:Organization
Organization Name:ANCHORED WELLNESS & RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUMFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:740-208-0057
Mailing Address - Street 1:2 ROSEMAR CIR
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1204
Mailing Address - Country:US
Mailing Address - Phone:740-208-0057
Mailing Address - Fax:740-446-9342
Practice Address - Street 1:2 ROSEMAR CIR
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1204
Practice Address - Country:US
Practice Address - Phone:304-483-7732
Practice Address - Fax:304-916-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-14
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH16970OtherLICENSE
OH0118790Medicaid
WV53521OtherLICENSE
WV3810028618Medicaid