| NPI | 1588913511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA RAGINS Clinical Supervisor 703-228-1592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0810000309) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |