| NPI | 1790095081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY THOMAS MALONE President/CEO 757-431-0105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1476) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2011-08-10 |