| NPI | 1235480351 |
|---|---|
| Doing Business As | CHILD/ADOLESCENT PSYCH PROGRAM |
| Entity Type | Organization |
| Authorized Contact | LEWIS ADDISON CFO 434-200-3656 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-09-28 |