| NPI | 1699280289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY Y SCOTT Owner 757-650-6125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: VA 0810003499) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2017-12-05 |