| NPI | 1073917860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M BROWN Owner 804-926-0991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904005572) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |