| NPI | 1205340650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MICHELLE SMITH-HICKS Executive Director 804-303-1496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |