| NPI | 1275921520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA BOURDON Director 757-345-6428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0803000251) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2015-01-08 |