| NPI | 1043999162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED SCOTT Owner 757-269-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2023-10-05 |