| NPI | 1245772177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVE GELLNER Clinical Supervisor 740-526-0204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV AP00940790) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |