| NPI | 1447763842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE ALLEN Mbr 703-615-7574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710103012) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |