| NPI | 1487278255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATRINA BANKS Owner 757-309-0104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2024-05-23 |