| NPI | 1013464361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN TOLBERT CEO 804-418-0876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904003315) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2016-09-03 |
| Last Update Date | 2022-07-07 |