| NPI | 1356903868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY NICHOLS Registered Agent/Executive Director 804-464-3462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-07-04 |
| Last Update Date | 2019-07-04 |