| NPI | 1093274474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY THOMAS Managing Member 757-799-8905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QU0200X Clinic/Center Urgent Care | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 251S00000X Community/Behavioral Health | |
| 253Z00000X In Home Supportive Care | |
| 261QE0002X Clinic/Center Emergency Care | |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2024-04-05 |