| NPI | 1215755095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY HINES Clinical Director 804-337-9048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2025-06-03 |