| NPI | 1003671892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT MILES CEO 757-770-6360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2024-10-22 |