| NPI | 1205165347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL D HENDRIX A/R Officer 304-257-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 1036-8848) |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2022-08-03 |