| NPI | 1952949687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY REDD CEO 804-313-6767 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2019-12-12 |