| NPI | 1760789317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANISHA HOLMES Director 703-969-6066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0701005911) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2015-02-17 |