| NPI | 1104283191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RASHA NICKERA HICKS Executive Director 804-683-8731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0701006414) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |