| NPI | 1093234155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIEL ADEYOLA Manager 804-833-8229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA 2038) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: VA 2038) |
| Enumeration Date | 2017-09-10 |
| Last Update Date | 2017-09-10 |