| NPI | 1881930253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GONZALO PAZ-SOLDAN Medical Director 703-271-8109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: VA 0904001756) |
| Additional Taxonomies | 261Q00000X (Licence: VA 0904001756) |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2012-12-12 |