| NPI | 1073737706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA DIANE HARDEN Executive Director 304-298-3262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: WV 145) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |