| NPI | 1215211982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA LYNN WATSON CEO 804-901-7823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1640) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2011-09-29 |