| NPI | 1225706468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY CORNELL Owner/Manager 757-618-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2022-06-14 |