| NPI | 1255005575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY L JOHNSON Qdip/ Owner 757-409-2851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 101Y00000X Counselor | |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2023-09-06 |