| NPI | 1821164583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE D VAUGHT Cs Iot COO Rdinator 434-392-3187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0701004337) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO 2459) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2008-07-01 |