| Laurel Place | |
|
812 Gorman Ave Elkins WV 26241-3181 | |
| (304) 636-3300 | |
| (304) 637-3867 |
| Full Name | Laurel Place |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 812 Gorman Ave, Elkins, West Virginia |
| Authorized Official Name and Position | William Lloyd Koch (CFO) |
| Authorized Official Contact | 3046373196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laurel Place Po Box 1484 Elkins WV 26241-1484 Ph: (304) 636-3300 | Laurel Place 812 Gorman Ave Elkins WV 26241-3181 Ph: (304) 636-3300 |
| NPI Number | 1770048043 |
|---|---|
| Provider Enumeration Date | 01/31/2019 |
| Last Update Date | 09/13/2023 |
| Certification Date | 09/13/2023 |
| Medicare PECOS PAC ID | 3072418540 |
|---|---|
| Medicare Enrollment ID | O20181213000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770048043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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