| NPI | 1316046956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LEWIS President 304-295-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: WV 26) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-07-21 |