| NPI | 1699407270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN A. GODWIN CEO 304-335-2050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2022-06-30 |