| NPI | 1205165636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA JOAN ROGERS Public Health Nurse 703-228-4996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: VA 0001151480) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2009-12-14 |