| NPI | 1417634478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWANDA CHANTELLE CHEATHAM Owner 804-389-3201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-06-30 |