| NPI | 1598396202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LYNN ROBERTSON Benefits Coordinator 304-792-7130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-01-31 |