| NPI | 1104170679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELIA LEA MCCAULEY-WITTL Operations Coordinator 540-400-7431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2025-01-07 |