| NPI | 1144069634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASONNA JOHNSON CEO 804-471-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-05-23 |
| Last Update Date | 2024-05-23 |