| NPI | 1013528504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY BENAY JAMES Owner 804-337-5337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |