| NPI | 1790036598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL VINCENT CALLAHAN CEO 757-321-8360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1111185297) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |