| NPI | 1215158324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MARIE PHIPPS Substance Abuse Counselor 276-963-3554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: VA LVN-164 X00000X) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |