| NPI | 1578922910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEZELINE LINDOR Clinical Director 571-379-8043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0701004758) |
| Enumeration Date | 2016-02-13 |
| Last Update Date | 2016-02-13 |