| NPI | 1285013599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCESCA MARIA DILLARD-MOORE CEO/ Co Owner 757-535-9153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2019-04-17 |