| NPI | 1073061354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY G SALE Partner Owner Provider Operator 804-248-1488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0904007840) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0701002831) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |