| NPI | 1639576895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA AZUCENA CORTEZ Manager 703-989-9482 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2025-09-04 |