| NPI | 1902282114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE PENDLETON Director Of Human Resources 757-397-1549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: VA 0024172811) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |