| NPI | 1609252618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY LAMONT GIGGETTS Owner 804-398-1974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904009074) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |