| NPI | 1073609525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA DAVIS Administrator 304-873-1531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: WV 008845) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |