| NPI | 1003658378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY GOODMAN CEO 757-613-6401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2024-06-08 |
| Last Update Date | 2024-07-09 |