| NPI | 1770267684 |
|---|---|
| Doing Business As | RANDOLPH CLINIC, LLC |
| Entity Type | Organization |
| Authorized Contact | NIK JEFFERSON OOI Partner 434-409-7543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2024-03-06 |