| NPI | 1528270493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA PRICE Authorized Official 304-623-5661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WV 20) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2018-04-30 |