| NPI | 1821849274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI LYNN MORRIS Owner 304-578-6355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |