| NPI | 1104161736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALINE NANKAM RN/ Supervisor 703-502-7005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: VA 0002052809) |
| Enumeration Date | 2012-12-08 |
| Last Update Date | 2012-12-08 |