| NPI | 1891907788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA PRICE Authorizaed Official 304-623-5661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: WV 20) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2018-04-30 |