| NPI | 1548604705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED CHRISTOPHER CONCA President 571-643-8715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA B301997) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2013-04-18 |