| NPI | 1659464477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE NICOLE JOHNSON Quality Assurance &Billing Manager 434-473-6955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-10-27 |