| NPI | 1578156741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RIVES WHITTLE THORNTON Executive Officer 304-319-0581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2021-02-18 |