| NPI | 1952270662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M BOGGS Authorized Agent 304-972-8383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-10-31 |
| Last Update Date | 2025-10-31 |