| NPI | 1679963904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN O'TOOLE-LYON Owner/Provider 804-255-9289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA 0904006918) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2023-03-07 |