| NPI | 1235229113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONNETTE M HAYES Program Director 804-222-3824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 64014001) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |