| NPI | 1821966995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 104100000X Social Worker | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry | |
| 363LF0000X Nurse Practitioner, Family | |
| 103T00000X Psychologist | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2025-10-29 |
| Last Update Date | 2025-10-29 |