| NPI | 1053081588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KWAME BAUBENG Owner 757-373-3551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-09-16 |