| NPI | 1205354479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE DUNCAN PHILLIPS CEO 304-556-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WV 2WV43M8DFJ) |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2017-09-07 |