| NPI | 1659023299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISETTE DE LEON COO/Office Manager 703-743-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-26 |