| NPI | 1295517647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY DODSON Owner 804-898-5322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2023-11-15 |