| NPI | 1023313590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERWIN HICKMAN Chief Executive Director 804-328-1979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 792-03-011) |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2011-01-14 |