| NPI | 1962253641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY HINES Executive Director 804-337-9048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2024-03-29 |
| Last Update Date | 2024-03-29 |