| NPI | 1184910978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE MATTHEWS Director 757-469-0332 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 990) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2020-06-26 |