| NPI | 1316456379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DABNEY CROSBY Owner 757-409-7613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2025-03-31 |