| NPI | 1053760868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA J. ELZA CEO 304-335-2050 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2016-10-12 |