| NPI | 1699123380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ROBERT MCCRACKEN CEO 571-237-4556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701004422) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2024-07-08 |