| NPI | 1215269915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA DAVIS MCMILLIAN Executive Director 757-420-8232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 101Y00000X) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2010-02-04 |