| NPI | 1780133223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN POTTS KIMBERLY Owner 703-254-4024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC C003850) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |