| NPI | 1194404442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SCHRECENGOST Nurse Practitioner 804-814-0107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-07-13 |