| NPI | 1386967057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA HARDESTY Co Owner 804-519-1360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |