| NPI | 1528740628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID NICHOLAS Revenue Cycle Director 703-825-8762 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-06-07 |