| NPI | 1639562713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE JONES CEO/Executive Director 434-401-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 25765) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2015-03-12 |