| NPI | 1700101581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY ARENDA JACKSON CEO 757-450-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1412) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-04-05 |