| NPI | 1811289333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE LEE BRYANT Owner 304-725-3461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 982) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |