Provider Demographics
NPI:1881202646
Name:GOD'S WAY HOME, INC.
Entity Type:Organization
Organization Name:GOD'S WAY HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:BAILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:130-464-6665
Mailing Address - Street 1:477 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAINELLE
Mailing Address - State:WV
Mailing Address - Zip Code:25962-1238
Mailing Address - Country:US
Mailing Address - Phone:304-646-6655
Mailing Address - Fax:
Practice Address - Street 1:477 MAIN ST
Practice Address - Street 2:
Practice Address - City:RAINELLE
Practice Address - State:WV
Practice Address - Zip Code:25962-1238
Practice Address - Country:US
Practice Address - Phone:304-646-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit