NPI | 1508420357 |
---|---|
Entity Type | Organization |
Authorized Contact | AMBER DAWN MOORE Owner 304-617-7859 |
Organization Subpart ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2019-04-26 |
Last Update Date | 2019-04-26 |