| NPI | 1720293582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY L MOORE Executive Director 757-877-7090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 333) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |