| NPI | 1356448930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE CARLETHIA COOPER Accounts Receivable Manager 757-247-0039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA 320) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2020-08-22 |