| NPI | 1154784965 |
|---|---|
| Other Name | JACKSON VA CARE SITE |
| Entity Type | Organization |
| Authorized Contact | ERIN POTTER Npi Team Member 202-382-2579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2017-10-04 |