| NPI | 1548495708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD LAMONT HEYWARD President 804-551-4155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: VA 07313155018008081414) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2009-05-18 |