| NPI | 1134530207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN DIAN SENIOR-WILLIAMSON Director Of Development 757-262-2094 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 981) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2014-05-12 |