| NPI | 1033631585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY REBECCA BURNETTE Office Manager 540-400-7841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-07-15 |
| Last Update Date | 2025-02-26 |