| NPI | 1144575572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGEN WYNEMA MAXWELL Office Manager 304-242-6722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2024-01-14 |