| NPI | 1598335820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA RENEE GROGG MEADOR Clinical Social Worker 304-914-1942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-08-11 |