| NPI | 1114274263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA SUE YOPP Owner 276-224-7403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1753) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2019-02-01 |