| NPI | 1831830769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADFORD STUCKI Owner 540-235-8330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-06-22 |