| NPI | 1053772673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRON NICOLE SHAW CEO 804-690-1879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005005) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102270) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0701005005) | |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2016-03-09 |