| NPI | 1235027137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI PALCIC Owner 757-356-2884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-06-27 |
| Last Update Date | 2025-08-22 |