| NPI | 1598634115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STELLA FRU Provider 703-200-9084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-11-03 |
| Last Update Date | 2025-11-03 |