| NPI | 1083252902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEONTE LYNELL MONTERIA Program Manager 804-549-6576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2019-12-12 |