| NPI | 1972920064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN TRIPPETT CEO 304-485-1721 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider (Licence: WV 23) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: WV 23) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2017-05-23 |