| NPI | 1770018855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LEE MUCKALEW Chief Executive Officer 681-319-1235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WV 2017971900) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |