| NPI | 1114706884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY CLARKE Director Of Applied Practice 434-989-0581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2023-09-22 |