| NPI | 1912197559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI BISTARKEY Clinical Director 434-447-8381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904004677) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: VA 823) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-07-30 |