| NPI | 1538869078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER THOMAS CEO 757-831-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2023-03-03 |