| NPI | 1083475784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CLAYTON HAYES Owner/Executive Director 757-291-4151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-01-19 |