| NPI | 1326248048 |
|---|---|
| Other Name | HOME BASE UPSHUR COUNTY GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | DAMON C. CATER CEO 304-472-8707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: WV 135) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |