| NPI | 1396140240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILAH MAXWELL Pharmacist In Charge 757-469-1803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: VA 2536) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |