| NPI | 1093250540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONNELL F LEWIS Licensed Clinical Social Worker 434-806-3869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 0904009706) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2019-10-11 |