| NPI | 1093223257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALTON TROY HENSHAW Counselor 804-393-4959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: VA 0701006455) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-01-22 |