| NPI | 1225859671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY GROSS COO 757-383-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker Clinical | |
| 1041S0200X Social Worker School | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM2800X Clinic/Center Methadone | |
| 342000000X | |
| 101Y00000X Counselor | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 101YS0200X Counselor School | |
| Enumeration Date | 2024-10-18 |
| Last Update Date | 2024-10-18 |