| NPI | 1538332630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA MALLARD GEORGE Co Executive Director 804-467-2606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 87105001) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-09 |