| Green Acres Regional Center Inc | |
|
7830 Ohio River Road Lesage WV 25537 | |
| (304) 762-2522 | |
| (304) 762-2862 |
| Full Name | Green Acres Regional Center Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 7830 Ohio River Road, Lesage, West Virginia |
| Authorized Official Name and Position | Emma Sue Smith (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3047622520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Acres Regional Center Inc Po Box 240 7830 Ohio River Road Lesage WV 25537 Ph: (304) 762-2522 | Green Acres Regional Center Inc 7830 Ohio River Road Lesage WV 25537 Ph: (304) 762-2522 |
| NPI Number | 1346318672 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346318672 | NPI | - | NPPES |
| 0004125000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Green Acres Regional Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7830 Ohio River Road, Lesage, WV 25537 Phone: 304-762-2522 Fax: 304-762-2862 |