| NPI | 1619053717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FIDGEON CEO 540-710-6085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 15802029) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |