| NPI | 1417534306 |
|---|---|
| Doing Business As | 12-2-1 ROUNDTABLES |
| Entity Type | Organization |
| Authorized Contact | JIM WILSON CEO 304-317-7776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2021-03-26 |