| NPI | 1205519386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONTAY N TILLMAN CEO 804-635-3442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-07-17 |