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 |