| NPI | 1174179337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN SAGE Owner 804-447-4794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2023-02-26 |