| NPI | 1811395726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE JOHNSON President 757-652-2916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 2267) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2023-12-19 |