NPI | 1962720060 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM TRAVIS CROCKER CEO 804-921-4611 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 709-11) |
Enumeration Date | 2010-05-13 |
Last Update Date | 2010-05-13 |