| NPI | 1831648583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAMWAWOSAYI ANDREW JATAU Owner 757-620-8539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0701005514) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |