| NPI | 1720864838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY JACKSON Chief Financial Officer 757-264-3012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2023-09-05 |