| NPI | 1023460912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA WALSTON Owner/CEO 703-924-9810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: VA 0024173415) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2021-04-27 |