| NPI | 1285148874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LEIGH HALSTEAD Director 304-806-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 16-121) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WV BP00942576) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |