Provider Demographics
NPI:1063579209
Name:FLORENCE CRITTENTON PROGRAMS, INC
Entity type:Organization
Organization Name:FLORENCE CRITTENTON PROGRAMS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF WELLSPRING
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:304-242-7060
Mailing Address - Street 1:2606 NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5370
Mailing Address - Country:US
Mailing Address - Phone:304-242-7060
Mailing Address - Fax:304-242-7076
Practice Address - Street 1:761 3RD ST
Practice Address - Street 2:
Practice Address - City:NEW MARTINSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26155-1403
Practice Address - Country:US
Practice Address - Phone:304-455-3035
Practice Address - Fax:304-455-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty