| NPI | 1972773133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANINE KEYUNI JACKSON Director 804-503-0466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1168) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-03-04 |