| NPI | 1710315981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM MORRIS Supervisory Social Worker 304-429-0287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: KY 3566) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |