| NPI | 1811747728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE RENA POWELL Owner 757-254-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-12-10 |