| NPI | 1073883518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON RASHAAN THOMPSON CEO 804-986-6332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 1761-02-029) |
| Additional Taxonomies | 251S00000X (Licence: VA 1761-02-014) |
| 251S00000X (Licence: VA 1761-03-001) | |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2015-11-09 |