| NPI | 1366528952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRILYN FARKAS VANTASSEL Executive Director 304-232-0233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: WV 93) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: WV 93) |
| 251J00000X Nursing Care (Licence: WV 93) | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: WV 93) | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: WV 93) | |
| 347C00000X Private Vehicle (Licence: WV 93) | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities (Licence: WV 93) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |