| NPI | 1295359941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN PUIG President 540-535-1112 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 251S00000X | |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2022-01-20 |