| NPI | 1184373938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATESHA SHANEE BROADUS Executive Director 757-778-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TC1900X Psychologist, Counseling | |
| 103K00000X Behavior Analyst | |
| 103TC0700X Psychologist, Clinical | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 106S00000X Behavior Technician | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2022-03-21 |