| NPI | 1720356165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIE L VAUGHAN President CEO 304-872-6503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WV 17) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2022-04-19 |