| NPI | 1124686464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY WRIGHT Director 757-342-6695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 106H00000X Marriage & Family Therapist | |
| 106S00000X Behavior Technician | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X | |
| 253J00000X Foster Care Agency | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2019-06-02 |
| Last Update Date | 2023-08-16 |