| NPI | 1578459483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATARA TWANIQUE LEWIS Owner 804-847-0116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-07-15 |