| NPI | 1356188411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY OLDS CFO 757-651-8765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-15 |