| NPI | 1023088077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA FUTRELL Chief Executive Officer 757-591-0643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2012-10-18 |