| NPI | 1962919506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BRIDENBAUGH CEO 740-773-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2020-07-31 |