| NPI | 1669824561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE A ESTEP Addictions Specialist 304-346-8829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WV 06-311) |
| Additional Taxonomies | 251S00000X (Licence: WV 22450179) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |