Cacapon Center For Growth, PLLC
Community/Behavioral Health in Berkeley Spring, WV. Organization (NPI-2).
NPI number1003420522
StatusActive
Last updated in NPPESSep 2, 2020
Details
- NPI
- 1003420522
- Entity type
- Organization (NPI-2)
- Legal business name
- Cacapon Center For Growth, PLLC
- Organization subpart
- No
- Enumeration date
- Sep 2, 2020
- Certification date
- Aug 26, 2020
- Last updated
- Sep 2, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
144 Grove Heights RoadBerkeley Spring, WV 25411-4816
Phone 304-500-8133
Mailing address
1855 Valley Rd # 368Berkeley Springs, WV 25411-4816
Phone 304-702-4426
Authorized official
Ryan Matthew Moon
Owner/Manager
3047024426
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