| NPI | 1750776068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY ENDLICH Director Of Credentialing & Privile 304-429-1088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2025-03-11 |