| NPI | 1922873702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TITIANA BAILEY Owner 304-919-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2023-11-21 |