| NPI | 1578397477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY JOSEPH Managing Member 540-761-9019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2024-09-02 |
| Last Update Date | 2024-09-02 |