| NPI | 1811399553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER DIANE LANE Owner 304-677-9324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services (Licence: WV 23037538) |
| Additional Taxonomies | 251B00000X Case Management (Licence: WV 23037538) |
| 251S00000X Community/Behavioral Health (Licence: WV 23037538) | |
| 252Y00000X Early Intervention Provider Agency (Licence: WV 23037538) | |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |