| NPI | 1730869595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE TUCKER-GUILFOYLE Member/Owner 804-924-7173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-07-18 |