| NPI | 1336685833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS MARIE MCLAURIN Sole Owner 757-749-0151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904007833) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |