| NPI | 1851790125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERI ANN FAYTON Owner 757-575-7690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0701005811) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2016-12-28 |