| NPI | 1487403366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP, Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-14 |