| NPI | 1588264626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMI DE LA VEGA Director Of Operations 757-296-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 261QM0801X | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |