| NPI | 1689389439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE TIARA BROWN Owner 804-495-9953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2025-02-25 |