| NPI | 1760147391 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JUSTIN MOORE Owner 804-605-6320 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst | 
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation | 
| 225XM0800X Occupational Therapist, Mental Health | |
| 235Z00000X Speech-Language Pathologist, | |
| 251B00000X Case Management | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| Enumeration Date | 2021-11-08 | 
| Last Update Date | 2025-07-07 |