| NPI | 1275877870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMONT ANTHONY ELLIS Executive Director 434-250-5784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD MH-1146) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2019-07-08 |