NPI | 1518104413 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL C FIDGEON COO 540-710-6085 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 158 02 029) |
Enumeration Date | 2009-01-14 |
Last Update Date | 2009-01-14 |