| NPI | 1013056167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE COOPER WATKINS M Caid Coordinator 757-247-0039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 320) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |