| NPI | 1760777189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MORIARTY Social Work Executive 802-295-9363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: NH 1598) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2011-06-14 |