| NPI | 1508455627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARNELLA EDWARDS Owner 757-606-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2021-01-13 |