| NPI | 1992495287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON GINEVAN Sr VP, Sud Services 304-223-4623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2023-05-10 |