| NPI | 1609389626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWANDA MARTIN Owner 757-867-5811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701006966) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2023-03-14 |