| NPI | 1215058987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY LEE CAIN Director 304-622-4786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 071752) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |