| NPI | 1790494409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE R. ARCHER-HUBBARD Member 757-761-1765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2023-11-09 |