| NPI | 1649953779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LYNN MANUEL Owner 304-404-4099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-07 |