| NPI | 1215752951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN SANDLIN Billing 304-886-4118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |