| NPI | 1043505530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATESHA MCINTOSH Licensed Clinical Social Worker 804-677-6958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC C006937) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2022-07-21 |