| NPI | 1225634298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAI MARIE CARTER Administrative Assistant 804-719-1966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2022-03-22 |