NPI | 1730404963 |
---|---|
Former Legal Business Name | YOUTH AND FAMILY DYNAMAICS DAY TREATMENT SUPPORT |
Entity Type | Organization |
Authorized Contact | ALLEN F JACKSON CEO 804-501-9440 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: VA 1162) |
Enumeration Date | 2010-03-31 |
Last Update Date | 2013-12-03 |