1200 West LLC
NPI #1871004077 in Blacksburg, Virginia
Provider Information
- NPI Number
- 1871004077
- Entity Type
- Organization
- Organization Name
- 1200 West LLC
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Oct 16, 2017
- Last Updated
- Oct 16, 2017
Practice Location
- Address
- 106 SOUTHPARK DR STE C
- City
- Blacksburg
- State
- Virginia
- ZIP Code
- 24060-6809
- Phone
- (540) 376-3348
Authorized Official
- Name
- DR. FRED MILACCI, D.ED
- Title
- OWNER
- Phone
- (434) 944-0487
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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