| NPI | 1033585542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT RUDDER Chief Executive Officer 304-622-1907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 13GR20) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |