| NPI | 1609543693 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KATHY L JOHNSON Owner 757-409-2851  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 106S00000X Behavior Technician | |
| 172V00000X Community Health Worker | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2021-08-26 | 
| Last Update Date | 2023-09-06 |