| NPI | 1073159380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL R TAPP Billing & Credentialing Specialist 434-219-5039 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2025-07-18 |