| NPI | 1598397630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY SPADE CEO 304-252-9211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 101Y00000X Counselor | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2022-02-22 |