| NPI | 1265924856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID FISHER Office Manager 434-264-3209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2024-04-29 |