| NPI | 1457112567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLA MCCARGO Director 703-712-3066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-01-17 |