| NPI | 1407999865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY WELTON SEE State Director 304-822-2670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 147) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2014-06-27 |