| NPI | 1881607414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM TRAVIS CROCKER Director Of Services 804-648-0671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 709-05-001) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2011-02-17 |