SAME

NPI # 

Practice Address:

65 Woods Edge Rd Unit 6

Fort Ashby, WV, 26719-9292

Practice Phone:

442-347-7045

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Mental Health (Including Community Mental Health Center)

Taxonomy Code:

261QM0801X