| NPI | 1952679490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVERY C LANDRUM Director 571-379-2359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904007330) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |