CACAPON CENTER FOR GROWTH, PLLC NPI 1003420522

Community/Behavioral Health in Berkeley Spring, WV

NPI 1003420522 Organization Community/Behavioral Health

About CACAPON CENTER FOR GROWTH, PLLC

Cacapon Center For Growth, Pllc is a provider established in Berkeley Spring, West Virginia specializing in community/behavioral health. The NPI number of Cacapon Center For Growth, Pllc is 1003420522 and was assigned on September 2020. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Ryan Matthew Moon Msw, Licsw (Owner/manager)

NPI

1003420522

Provider NameCACAPON CENTER FOR GROWTH, PLLC
Provider Location Address144 GROVE HEIGHTS ROAD BERKELEY SPRING, WV 25411
Provider Mailing Address1855 VALLEY RD # 368 BERKELEY SPRINGS, WV 25411
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-02-2020
Last Update Date09-02-2020


Primary Taxonomy

Taxonomy Code251S00000X
ClassificationCommunity/Behavioral Health
TypeAgencies
Taxonomy DescriptionA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Business Address

CACAPON CENTER FOR GROWTH, PLLC
144 GROVE HEIGHTS ROAD
BERKELEY SPRING, WV
ZIP 25411
Phone: (304) 500-8133

Get Directions


Mailing Address

CACAPON CENTER FOR GROWTH, PLLC
1855 VALLEY RD # 368
BERKELEY SPRINGS, WV
ZIP 25411
Phone: (304) 702-4426



Authorized Official

Authorized Official Name RYAN MATTHEW MOON MSW, LICSW
Authorized Official TitleOWNER/MANAGER
Authorized Official Phone(304) 702-4426

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.