| NPI | 1497906663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS DAVID LINZ Member 304-412-1637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WV 550) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |