NPI | 1164880993 |
---|---|
Entity Type | Organization |
Authorized Contact | ALVA CARTER KERSHAW Clinical Supervisor 804-539-3117 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904006909) |
Enumeration Date | 2016-02-08 |
Last Update Date | 2016-02-08 |