| NPI | 1669356705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKEA RIVERS Owner 757-354-1469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251E00000X Home Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-08-01 |
| Last Update Date | 2025-08-11 |