| NPI | 1649853417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETCH SHAHEEN Executive Director 757-310-3809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 261QE0002X Clinic/Center, Emergency Care | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2021-04-30 |