| NPI | 1922753193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IFEOMA NKEMDILIM JENNIFER ELEBO Administrator 804-528-9752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 261QP2300X Clinic/Center Primary Care | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 363LP2300X Nurse Practitioner Primary Care | |
| 363LW0102X Nurse Practitioner Women's Health | |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2024-08-26 |