| NPI | 1013459627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CHARLES RICHARDS Counselor 304-366-7288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV BP00944922) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |