| NPI | 1578628228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN WAYNE WATTS Director & Supervisor 304-263-6205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 294) |
| Enumeration Date | 2006-12-23 |
| Last Update Date | 2020-08-22 |