| NPI | 1396318135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLIE MANUEL Owner 434-381-0902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2023-08-10 |