| NPI | 1053725309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA CAPAGE Executive Director 304-598-0344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2014-06-15 |
| Last Update Date | 2014-06-15 |