| NPI | 1518788421 |
|---|---|
| Doing Business As | KALEIDOSCOPE CARE CLINIC |
| Entity Type | Organization |
| Authorized Contact | LOIS WALTERS-THREAT CEO 804-299-5590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2024-10-23 |