| NPI | 1205823853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK KETTERLINUS CFO 804-282-5644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103G00000X Clinical Neuropsychologist | |
| 103TC0700X Psychologist, Clinical | |
| 251E00000X Home Health (Licence: VA 497554) | |
| 253Z00000X In Home Supportive Care | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2025-02-17 |