| NPI | 1467805671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD PAUL GUYTON Owner 757-286-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904006140) |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |