| NPI | 1457727158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK MELVIN Owner/COO 757-227-4644 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: VA 2017) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2015-08-17 |