| NPI | 1942902093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HERZOG President 804-955-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2023-03-21 |