| Organization Name: | GOOCHLAND POWHATAN COMMUNITY |
| NPI Number: | 1467448571 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN E BERGQUIST (EXECUTIVE DIRECTOR) |
| Mailing Address: | 3058 River Rd W Goochland |
| State: | VA US |
| Postal Code: | 230633202 |
| Phone Number: | 8045565400 |
| Fax Number: | 8045565403 |
| NPI Enumeration Date: | 09/23/2005 |
| NPI Last Update Date: | 06/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 207 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |