| NPI | 1023874591 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JOSHUA ALI WASHINGTON Owner 804-482-9344 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Additional Taxonomies | 251B00000X Case Management | 
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-02-22 | 
| Last Update Date | 2025-04-13 |