| NPI | 1144592668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA TOLLIVER CEO 276-732-9588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904000858) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2012-01-30 |