| NPI | 1659178143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY MICHELLE TAIT Owner 804-647-2695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-03-19 |