| NPI | 1487486221 |
|---|---|
| Former Legal Business Name | TRANSITIONAL WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | TARA PATRCIA DAVIS CEO/Owner 757-407-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-10-07 |