| NPI | 1881883007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY CAUSEY Chief Executive Officer 804-253-1968 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2022-11-17 |