| Cacapon Center For Growth, Pllc | |
|
144 Grove Heights Road Berkeley Spring WV 25411-4816 | |
| (304) 500-8133 | |
| Not Available |
| Full Name | Cacapon Center For Growth, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 144 Grove Heights Road, Berkeley Spring, West Virginia |
| Authorized Official Name and Position | Ryan Matthew Moon (OWNER/MANAGER) |
| Authorized Official Contact | 3047024426 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cacapon Center For Growth, Pllc 1855 Valley Rd # 368 Berkeley Springs WV 25411-4816 Ph: (304) 702-4426 | Cacapon Center For Growth, Pllc 144 Grove Heights Road Berkeley Spring WV 25411-4816 Ph: (304) 500-8133 |
| NPI Number | 1003420522 |
|---|---|
| Provider Enumeration Date | 09/02/2020 |
| Last Update Date | 09/02/2020 |
| Certification Date | 08/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003420522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |