| NPI | 1558881128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELLO MADISON President/CEO 757-921-2762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701007132) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2024-03-01 |