| NPI | 1073049946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DHAIMA MARTIN CEO 757-918-5481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA S4757185) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |