| NPI | 1629892856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HORACE FENTON SMITH Owner / CEO 434-632-4840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2024-11-13 |