| NPI | 1558415968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID NICHOLAS Revenue Cycle Director 703-825-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: VA 122-14-002) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: VA 122) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: VA 122-01-006) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: VA 122-01-007) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: VA 122-01-11) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: VA 122-14-003) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: VA 122-14-001) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2024-05-13 |