| NPI | 1396797825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE MCCOY President 304-428-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 103TC0700X Psychologist Clinical | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WV 19159) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2009-11-18 |