| NPI | 1811708167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANICA L WALSTON CEO / Therapist 804-677-5763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2025-01-16 |