| NPI | 1417606831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW SCOTT DORNBOS General Counsel 304-541-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2022-03-22 |