| NPI | 1407365943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY MOORE Owner 757-419-1871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0701005610) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2017-09-27 |