| NPI | 1215295688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN JONES Director 304-699-4750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 129) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2022-05-06 |