| NPI | 1649839978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN NICOLE BAILEY Owner 757-854-9688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2024-12-20 |