| NPI | 1265022867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYREETA MAE CHANCE Chief Executive Officer 757-955-6059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2024-01-03 |