| NPI | 1619726429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADISLAVA OLEGOVNA SYNENKO Nurse Practitioner 757-207-3655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2025-11-04 |