| NPI | 1366230229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SHORT Senior Compliance Specialist 304-503-3448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-04-29 |