| NPI | 1831756790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORLA JOHNSON Chief Executive Officer 757-353-2631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2024-12-20 |