| NPI | 1366033615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALECIA ALLEN Statewide Clinical Director 304-881-7736 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-01-29 |
| Last Update Date | 2021-09-30 |