| NPI | 1336106632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ROSCOE MAYS CEO 304-583-6541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2020-08-22 |