| NPI | 1568084937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA E SARGENT Registered Agent 757-744-9689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |