| NPI | 1265819874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA E MCCOY Owner 434-218-0703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA 0904007133) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2022-11-11 |