| NPI | 1790575116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA FUTRELL Chief Executive Officer 757-591-0643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-06-02 |