| NPI | 1467116087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE LOFTIN Executive Director 757-849-9912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2022-06-27 |