Provider Demographics
NPI:1851075253
Name:NEW RIVER RANCH INC
Entity Type:Organization
Organization Name:NEW RIVER RANCH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DEVELOPMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-574-1058
Mailing Address - Street 1:PO BOX 178
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25840-0178
Mailing Address - Country:US
Mailing Address - Phone:304-574-1058
Mailing Address - Fax:304-574-3427
Practice Address - Street 1:351 NEW RIVER RANCH DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:WV
Practice Address - Zip Code:25840-6220
Practice Address - Country:US
Practice Address - Phone:304-574-1058
Practice Address - Fax:304-574-3427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty