| NPI | 1467934828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LORIEN WILDER Owner 804-426-3728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-09-03 |
| Last Update Date | 2018-09-03 |