| NPI | 1225594922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAINA JENKINS Owner 804-239-9597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2023-04-17 |