| NPI | 1780451112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY-BETH N. BRUBECK Chief Financial Officer 304-525-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2023-12-06 |