Sugar Grove MBH-Ga, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SUGAR GROVE MBH-GA, LLC

Practice address

133 Hedrick Dr
Sugar Grove, WV 26815-5068

Phone

(304) 348-1079

NPI assigned

Mar 15, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Cynthia Persily

Title

Ceo

Phone

(304) 348-1421

Specialties & licenses 1

Addresses

Other names 1

• The Highlands at Sugar Grove Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nohl Arthur Braun Jr., M.D.

  • Psychiatry Physician
  • Charleston, WV
  • NPI 1013933340
  NPD (past)
• Diana Joyce Martin, M.D.

  • Internal Medicine Physician
  • Charleston, WV
  • NPI 1720004062
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1346743481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4107",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253644107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 HEDRICK DR",
            "city": "SUGAR GROVE",
            "state": "WV",
            "postal_code": "268155068",
            "telephone_number": "304-348-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGAR GROVE MBH-GA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "PERSILY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-348-1421",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Highlands at Sugar Grove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Pultz
• Ivory Rader
• Patricia A. Rexrode
• Janet Riggleman
• Kimberley Riggleman
• Brittany Turner
• Walter Reed National Military Med Center
• Linda Marie Wimer

• Substance Abuse Rehabilitation Facility in Sugar Grove, WV
• Providers in Sugar Grove, WV by specialty
• Substance Abuse Rehabilitation Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.