NPI | 1508264169 |
---|---|
Entity Type | Organization |
Authorized Contact | PENELOPE J DONOVAN Lpc 571-249-3843 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 07010055900) |
Enumeration Date | 2014-12-15 |
Last Update Date | 2014-12-15 |