| NPI | 1487855003 |
|---|---|
| Former Legal Business Name | NA |
| Entity Type | Organization |
| Authorized Contact | JERI DICKINSON LEWIS Director 804-398-8401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701002806) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |