| NPI | 1043612104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON C HUDSON Executive Director 804-621-4034 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 2548) |
| Enumeration Date | 2014-09-20 |
| Last Update Date | 2017-02-06 |