Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction Medicine |
207QA0401X | 08 | Physician/Family Practice | |
Addiction (Substance Use Disorder) |
101YA0400X | |||
Addiction (Substance Use Disorder) |
163WA0400X | |||
Addiction Medicine |
207RA0401X | 11 | Physician/Internal Medicine | |
Licensed Practical Nurse |
164W00000X | |||
Mental Health |
101YM0800X | |||
Other Service Providers |
175T00000X | |||
Professional |
101YP2500X |
| NPI Number | 1255047759 |
| LBN Legal business name | BAYMARK HEALTH SERVICES OF WEST VIRGINIA, INC. |
| Authorized official | BRUCE JARVIE - (VP, TREASURER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/27/2023 |
| Last updated | 07/29/2024 - More than a year ago |
| Identifiers | n/a |
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