| NPI | 1760201057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE SHIN Clinical Director 804-904-9429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-10-04 |
| Last Update Date | 2025-05-12 |