| NPI | 1316835317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN MOORE Chief Executive Officer 804-605-6320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225XM0800X Occupational Therapist, Mental Health | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-07-07 |