| NPI | 1184203176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONDA LATOYISHA WARREN-LILLY Owner 757-822-9139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-06 |