| NPI | 1629725478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTAL R JENKINS Owner 804-621-5572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2023-01-24 |