| NPI | 1316394679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID STEVENS Director 304-363-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WV 2321-8541) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2016-05-17 |