| NPI | 1447585443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLETTA PATRICE HIGHSMITH Site Coordinator 804-928-9865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 125802001) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2009-10-08 |