| NPI | 1528716099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD JOHNSON CAO 804-510-4920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2023-10-17 |