| NPI | 1942054168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN RICKS CEO 804-293-0470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-11-21 |