| NPI | 1255633582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY NICOLE HASSELL Chief Executive Officer 757-955-5479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1701) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2012-06-29 |