| NPI | 1215230685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LOONEY Team Leader 304-232-0587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV DP00942969) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |