| NPI | 1164241097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIA LYNN DOUMBIA Director 804-245-5608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2024-10-08 |