| NPI | 1568883569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA PHELPS CORBIN Operations Manager 757-228-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1679) |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2013-12-18 |