| NPI | 1578079430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA CLAIBORNE Owner 757-812-0891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-14 |