| NPI | 1780192039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE FRED MILLER Owner 804-919-7671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1684-03-001) |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-06-16 |