| NPI | 1164029898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORRIS SHERMON Executive Director 757-477-9416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |