| NPI | 1497279434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND V TAYAG President/CEO 276-224-0949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 2696-03-001) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |