| NPI | 1114355245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY DEAN HORNBACK Owner 540-526-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1942-03-001) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |