| NPI | 1841221504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW KIRK SLABAUGH Owner 804-615-2325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-04-19 |