| Grafton Integrated Health Network | |
|
46 Trifecta Pl Suite 105 Charles Town WV 25414-5652 | |
| (304) 725-4536 | |
| Not Available |
| Full Name | Grafton Integrated Health Network |
|---|---|
| Speciality | Behavior Analyst |
| Location | 46 Trifecta Pl, Charles Town, West Virginia |
| Authorized Official Name and Position | Vanessa Lane (DIRECTOR, CYCLE MNGT./ACCOUNTS RECE) |
| Authorized Official Contact | 5405420200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grafton Integrated Health Network Po Box 2500 Winchester VA 22604-1700 Ph: () - | Grafton Integrated Health Network 46 Trifecta Pl Suite 105 Charles Town WV 25414-5652 Ph: (304) 725-4536 |
| NPI Number | 1043674005 |
|---|---|
| Provider Enumeration Date | 04/06/2016 |
| Last Update Date | 05/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043674005 | NPI | - | NPPES |
| 3810025462 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 425 (West Virginia) | Primary |
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