| NPI | 1467152363 |
|---|---|
| Other Name | NA |
| Entity Type | Organization |
| Authorized Contact | SHEQWANA GENEVA ROGERS Owner 804-835-1799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2023-03-08 |