| NPI | 1205058773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISSA STEWART Executive Director 304-523-9454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WV 1678) |
| 101Y00000X Counselor (Licence: WV 27907) | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2015-12-22 |