| NPI | 1407080484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAGIB ELBASHIR President 804-330-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA C1S0313) |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2009-05-08 |