| NPI | 1912468190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERODNICKER BROWN Program Director 804-519-4448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-03-28 |