| NPI | 1992221949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH FEARNOW Owner 540-760-1820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: IN 39002947A) |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: IN 39002947A) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2022-07-21 |