| NPI | 1013407659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY TUCKER Owner/Program Director 804-895-2106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2025-09-11 |