| Lilys Place Family Center | |
|
1235 6th Ave Huntington WV 25701-2904 | |
| (304) 523-5459 | |
| (304) 523-8341 |
| Full Name | Lilys Place Family Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1235 6th Ave, Huntington, West Virginia |
| Authorized Official Name and Position | Rebecca Dawn Crowder (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3045235459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lilys Place Family Center Po Box 2 Huntington WV 25706 Ph: (304) 523-5459 | Lilys Place Family Center 1235 6th Ave Huntington WV 25701-2904 Ph: (304) 523-5459 |
| NPI Number | 1689288813 |
|---|---|
| Provider Enumeration Date | 09/04/2020 |
| Last Update Date | 10/12/2020 |
| Certification Date | 10/12/2020 |
| Medicare PECOS PAC ID | 6709275902 |
|---|---|
| Medicare Enrollment ID | O20211109002491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689288813 | NPI | - | NPPES |
| 3910005949 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Stephanie Dawn Vanover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023523545 PECOS PAC ID: 1850780073 Enrollment ID: I20211109003184 |
| Provider Name | Jessica Dawn Napier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184348823 PECOS PAC ID: 4789020991 Enrollment ID: I20240311002186 |
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