| NPI | 1316276603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY RYAN KIDD President/Director 703-281-9313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904001855) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2009-12-15 |