| NPI | 1124255468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE HEARNE WENTLAND President 757-817-7125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA PBS Provider 144) |
| Enumeration Date | 2009-06-13 |
| Last Update Date | 2009-06-13 |