| NPI | 1518622075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRELL GROSS Co Owner 757-373-9284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 251S00000X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2021-11-01 |