| NPI | 1033347414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA THOMPSON CEO 304-897-5915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| 124Q00000X Dental Hygienist | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2024-01-16 |