| NPI | 1659464873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE SANDRA WHITAKER Owner 757-838-4144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0904001171) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA 0904001171) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-09-06 |