| NPI | 1063669414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA SMITH House Supervisor 804-640-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 1261) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2009-11-20 |