| NPI | 1255513628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN ROYAL LOVE Presidednt 804-934-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 0101051656) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-12-04 |