| NPI | 1659523785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRBY CAMPBELL Owner 540-556-2292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 711-03-001) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |