| NPI | 1174649347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL ALAN CLIFFORD CFO Treasurer 304-768-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WV 94) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |