| NPI | 1780133280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE FOUNTAIN Owner/CEO 804-677-0379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904005723) |
| Enumeration Date | 2016-09-25 |
| Last Update Date | 2016-09-25 |