| NPI | 1699520528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDRA FULLARD Owner 757-342-6695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 251E00000X Home Health | |
| Enumeration Date | 2024-04-23 |
| Last Update Date | 2024-04-23 |