| NPI | 1083505440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISHTA GUPTA CFO 703-629-5768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2025-07-15 |