| NPI | 1427522218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA L ROBERTSON Benefits Coordinator 304-792-7130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 208D00000X General Practice |
| 261QC1500X Clinic/Center, Community Health | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2020-01-28 |