| NPI | 1396177218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUAN WINSTON Director 804-647-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 2058) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2013-08-01 |