| NPI | 1043010630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LEACH CEO 304-824-5806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-03-14 |