| NPI | 1659594638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK FAZZOLARI Executive Director 304-340-3676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 131) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |