| NPI | 1336023712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON M WISE Operations Manager 304-282-7632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-07-31 |
| Last Update Date | 2025-07-31 |