| NPI | 1912033952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE JEAN KEES Administrator 304-469-2291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WV 8BH635) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |