| NPI | 1194790089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY-BETH BRUBECK Vice President Of Finance / CFO 304-525-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 103T00000X Psychologist |
| 363L00000X Nurse Practitioner | |
| 207V00000X Obstetrics & Gynecology | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2022-03-31 |