| NPI | 1730457987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD H KILEY Executive Director 304-636-3232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: WV 1) |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2011-12-02 |