| NPI | 1114296571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN THOMAS REDD CEO 540-368-0614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 492-03-003) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 492-03-003) |
| 101YP2500X Counselor, Professional (Licence: VA 492-07-004) | |
| 251E00000X Home Health (Licence: VA 492-03-003) | |
| 251S00000X (Licence: VA 492-07-004) | |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2011-12-14 |