| NPI | 1306157243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELORES THOMAS Executive Director 757-595-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 113905001) |
| Additional Taxonomies | 251S00000X (Licence: VA 113903001) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |