| NPI | 1891252938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADE JABORI MASON CEO 804-621-3692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |