| NPI | 1124796867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIKKA L MASON Chief Clinical Officer 804-721-3306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-11-19 |