| NPI | 1790176220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BAKER CEO 804-255-0925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 93001001) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-02-05 |