| NPI | 1922761352 |
|---|---|
| Doing Business As | VALECIA JACKSON |
| Entity Type | Organization |
| Authorized Contact | ANTOINITA C STOKES Consultant 804-613-0087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 172V00000X Community Health Worker | |
| 251S00000X Community/Behavioral Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2021-10-21 |