| NPI | 1174985717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH C MAYO Business Manager 304-208-3715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 23162423) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |