| NPI | 1083428734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY MICHELLE KOCHER Community Liaison 304-455-3035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-02-04 |
| Last Update Date | 2025-02-04 |