| NPI | 1467711150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DONOVAN BECKETT Medical Director 304-236-5902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WV 1875) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2023-07-31 |