| NPI | 1639746654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI NICOLE DUNGEE Owner 804-475-1512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2021-06-08 |