Provider Demographics
NPI: | 1437542347 |
---|---|
Name: | PRESTERA CENTER FOR MENTAL HEALTH SERVICES INC |
Entity type: | Organization |
Organization Name: | PRESTERA CENTER FOR MENTAL HEALTH SERVICES INC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LISA |
Authorized Official - Middle Name: | IRENE |
Authorized Official - Last Name: | ZAPPIA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MBA, MA, NCC, LPC |
Authorized Official - Phone: | 304-399-7760 |
Mailing Address - Street 1: | 99 CRACKER BARREL DR STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | BARBOURSVILLE |
Mailing Address - State: | WV |
Mailing Address - Zip Code: | 25504-1650 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 304-525-7851 |
Mailing Address - Fax: | 304-525-1073 |
Practice Address - Street 1: | 3375 US ROUTE 60 |
Practice Address - Street 2: | |
Practice Address - City: | HUNTINGTON |
Practice Address - State: | WV |
Practice Address - Zip Code: | 25705-2837 |
Practice Address - Country: | US |
Practice Address - Phone: | 304-525-7851 |
Practice Address - Fax: | 304-525-1073 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-03-17 |
Last Update Date: | 2024-10-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 291U00000X | Laboratories | Clinical Medical Laboratory |