| NPI | 1053753343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERINN ILYSE FALLS Owner 434-414-7203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904007808) |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2016-07-22 |