| NPI | 1124676564 |
|---|---|
| Other Name | MOODY |
| Entity Type | Organization |
| Authorized Contact | DYVERYNCE VAUGHAN Owner/Chief Executive Officer 757-955-4073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2021-11-05 |