| NPI | 1497175814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASONYA GREEN Program Director/Owner 757-270-6563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 38988) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-04-24 |