| NPI | 1679060420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDNA GREEN Associate Director Operations 304-768-7688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2020-10-19 |