| NPI | 1386333656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTA NICOLE HANEY Clinical Director 304-644-6620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2025-03-24 |