| NPI | 1073160701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BARRY Executive Director 304-901-5172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2020-04-02 |