| NPI | 1033044979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILSHAT SABITOV Managing Member/Authorized Official 703-364-9977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2026-06-13 |
| Last Update Date | 2026-06-29 |