| NPI | 1669066858 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | RYAN MICHAEL FIELDS Owner/Member 304-972-9447  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Additional Taxonomies | 101YP2500X Counselor, Professional | 
| 1041C0700X Social Worker, Clinical | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2021-02-27 | 
| Last Update Date | 2025-08-19 |