| NPI | 1841954419 |
|---|---|
| Other Name | NONE |
| Entity Type | Organization |
| Authorized Contact | DENISE DIANNE COOPER Owner/Practitioner 804-836-9729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2021-10-28 |