| NPI | 1417694605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIERRA HEREFORD Owner 540-358-0423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2025-12-26 |