| NPI | 1720622129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA CALLAHAN Managing Member 757-372-7868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |