| Yellow Brick Road, Inc. | |
|
1510 4th St Moundsville WV 26041-1733 | |
| (304) 551-1279 | |
| Not Available |
| Full Name | Yellow Brick Road, Inc. |
|---|---|
| Speciality | Case Management |
| Location | 1510 4th St, Moundsville, West Virginia |
| Authorized Official Name and Position | Amy Jo Wilson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3045511279 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Yellow Brick Road, Inc. 1510 4th St Moundsville WV 26041-1733 Ph: () - | Yellow Brick Road, Inc. 1510 4th St Moundsville WV 26041-1733 Ph: (304) 551-1279 |
| NPI Number | 1285898726 |
|---|---|
| Provider Enumeration Date | 07/14/2008 |
| Last Update Date | 07/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285898726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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