NPI | 1851787121 |
---|---|
Doing Business As | GENESIS YOUTH CRISIS WELLNESS CENTER |
Doing Business As | ADAMSTON ELEMENTARY SCHOOL WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | DORA L POTASNIK Credentialing 304-587-2541 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2015-04-13 |
Last Update Date | 2024-01-19 |