| NPI | 1356193866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIONNE SMITH Owner 757-955-0259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2024-04-08 |