| NPI | 1073753158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERLINE HOPSON Owner 804-439-0344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: VA Ho8115000) |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 305S00000X Point of Service | |
| 251J00000X Nursing Care | |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2013-03-14 |