| NPI | 1962831669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON SAMPSON Virginia State Director 5407-100-6085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 158 07 010) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |