| NPI | 1194414805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HERZOG CEO/Co Founder 804-955-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 207Q00000X Family Medicine | |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2024-08-17 |