| NPI | 1104371350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ABDELMAGID Owner 804-252-4118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1492-03-001) |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2016-08-17 |