Organization · NPI-2

Baymark Health Services Of West Virginia, INC.

Family Medicine, Addiction Medicine · Morgantown, WV

NPI number1255047759

StatusActive

Last updated in NPPESJul 29, 2024

Details

NPI: 1255047759
Entity type: Organization (NPI-2)
Legal business name: Baymark Health Services Of West Virginia, INC.
Organization subpart: No
Enumeration date: Jan 27, 2023
Certification date: Jul 29, 2024
Last updated: Jul 29, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207QA0401X	Family Medicine, Addiction Medicine	–	–	Yes
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–
101YM0800X	Counselor, Mental Health	–	–
101YP2500X	Counselor, Professional	–	–
163WA0400X	Registered Nurse, Addiction (Substance Use Disorder)	–	–
164W00000X	Licensed Practical Nurse	–	–
175T00000X	Peer Specialist	–	–
207RA0401X	Internal Medicine, Addiction Medicine	–	–

Other names

Medmark Treatment Centers Morgantown (Doing Business As)

Practice location

53 Don Knotts Blvd
Morgantown, WV 26508-6838

Phone 304-284-0025 · Fax 304-284-0031

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425

Phone 469-470-4779 · Fax 214-481-7740

Authorized official

Bruce Jarvie
Vp, Treasurer
2143793300

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