| NPI | 1558896993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDAL JOHNSON Executive Director 304-436-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 384) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |