| NPI | 1134543242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA FELICIA JONES Clinical Director/Co Pastor 804-957-6389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 251S00000X (Licence: VA 09044003479) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2016-02-04 |