| NPI | 1396196358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA JEAN LEE Owner/Director 304-960-9348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: NC 252Y00000X) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NC 251B00000X) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2016-06-30 |