| NPI | 1780728766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI FIELDS Regional Director 304-822-2670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 147) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |