| NPI | 1437026671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 207RA0000X Internal Medicine, Adolescent Medicine | |
| 101Y00000X Counselor | |
| 104100000X Social Worker | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2025-10-22 |
| Last Update Date | 2025-10-22 |