| NPI | 1073161956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ERIC ROMAN CEO 804-721-7528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2020-08-20 |