| NPI | 1780058628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA STAPLES CFO 434-818-7880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2026-08-31 |