| NPI | 1912748211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA QUEEN Owner/Therapist 304-812-5426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2025-01-17 |