| NPI | 1356607832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON KAMENCIK CFO 804-612-3317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 295-05-001) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2020-09-24 |