| NPI | 1720122146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONITA H JANTZI Partner 540-434-2848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA 1074) |
| Enumeration Date | 2007-02-18 |
| Last Update Date | 2009-03-11 |