| NPI | 1962800359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE M MILLER Owner 703-795-7929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0810004945) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2014-12-17 |