| NPI | 1801646047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARDELL C PATILLO Executive Director / Owner 757-962-8005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-03-22 |
| Last Update Date | 2024-03-22 |