| NPI | 1356959654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA-TOYA JENKINS Employee 804-404-8241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2022-09-21 |