| NPI | 1871015669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL YOSEF DAVIS Director 703-975-6415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: DC 400317001920) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2017-07-13 |