| NPI | 1689706301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LEE ANDERSON Substance Abuse Counselor 757-344-0459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 0710102044) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |