| NPI | 1063380525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 104100000X Social Worker |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2025-10-27 |