| NPI | 1487505814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HERZOG Manager 804-955-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2026-02-03 |
| Last Update Date | 2026-02-03 |