| NPI | 1881270205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA SOVIA State Director 304-280-4578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-03-24 |