| NPI | 1841501939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIE A. MANIS Manager 540-958-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA 0701004657) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |