| NPI | 1598306649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOO-RHEE JACOB Authorized Official 703-546-1834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2024-07-18 |