| NPI | 1003152737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY O. WELLS Owner 540-818-3379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0810004613) |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2012-12-28 |