| NPI | 1104177674 |
|---|---|
| Doing Business As | BUCKHANNON-UPSHUR HIGH SCHOOL WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | RICHARD G SIMON CEO 304-924-6262 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WV 2273-6226) |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2012-10-02 |