| 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 |