| NPI | 1588086177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONEIKO HENDERSON-BEASLEY Owner/Director 757-287-4990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: VA 0904008490) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |