| NPI | 1093970105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY EUGEN GROSS President 757-831-2921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 19778) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2008-07-29 |