| NPI | 1053868232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMAR LEVELL JOHNSON CEO/Director 757-535-8654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 2405) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2016-09-06 |