Alta Vista Children'S Shelter

LBN: Genesis Youth Crisis Center, Inc.
Alta Vista Children'S Shelter is an health care organization with primary practice located at 261 Haymond Hwy , Clarksburg WV 26301-3868. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Genesis Youth Crisis Center, Inc. can be contacted via phone (304) 622-3339, or through Rudder, Matt via phone (304) 622-1907.

Contact Information

Primary practice address
261 Haymond Hwy Clarksburg WV 26301-3868
Phone: (304) 622-3339
Fax: (304) 622-3433
Website:
Map and Directions
Authorized official contact:
Name: Rudder, Matt
Phone: (304) 622-1907

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1932318086
LBN Legal business name Genesis Youth Crisis Center, Inc.
DBA Doing business as Alta Vista Children'S Shelter
Authorized official Rudder, Matt
Entity Organization
Organization subpart 1 No
Enumeration date May 22nd, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932318086 NPPES
West Virginia MEDICAID 0902105000

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