| NPI | 1043682057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE GUALAZZI Chief Operating Officer 304-284-0025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: WV 09) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |