| NPI | 1467669226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES FREDERICK PHIFER Executive Director 304-781-2510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |