| NPI | 1659812022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERODNICKER TAMAR BROWN Owner 804-519-4448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA RBT1506136) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-03-17 |