| NPI | 1790152775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ADCOCK Program Director 540-735-9350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: VA 0701006241) |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2015-08-26 |