| NPI | 1255620951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BALOY Director 757-838-1894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2020-11-12 |