| NPI | 1588073704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATESHA SHANEE CROMWELL Provisional Outpatient Therapist 757-751-5328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC P009061) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2014-08-13 |