| NPI | 1922470210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUSTIN HICKS District Manager 703-516-6951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA BLC10015648503) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |