| NPI | 1942528336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE BRAGG PERRY Director 304-528-5815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WV 1728) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WV AP00940567) |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2010-05-10 |