| NPI | 1760663306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWANNA CHENA MITCHELL-JONES Clinical Director 804-745-1250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2007-11-26 |