| NPI | 1801606348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALASHA NEWBROUGH Accounting Manager 304-643-4005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |