| NPI | 1881136059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETITIA LAURIEN CEO 757-503-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904007077) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |