| NPI | 1336735638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY CAUSEY CEO 804-253-1968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2022-11-17 |