| NPI | 1669635546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE CHRISTINE MCCREARY CEO 804-502-0272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 1109) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2008-07-09 |