| NPI | 1457906810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA THOMPSON Owner 804-384-6126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2019-08-02 |