| NPI | 1528594470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEREDITH A MARTIN Owner 757-329-6790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0133000176) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |