| NPI | 1023874591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA ALI WASHINGTON Owner 804-482-9344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-02-23 |