| NPI | 1104305945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE J WIMBISH CEO 757-343-1683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: VA 2908-03-001) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |