| NPI | 1770093254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATROYAL SMITH Owner 804-651-6204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |