| NPI | 1295198752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN LEE WISEMAN CEO 540-220-2633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101250845) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |