| NPI | 1134199193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA WILLIS Executive Director 757-397-0042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2023-02-23 |