NPI | 1912242124 |
---|---|
Entity Type | Organization |
Authorized Contact | COREY ANTWON OLDS Chief Operations Officer 757-595-8008 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1571-01-001) |
Enumeration Date | 2012-11-29 |
Last Update Date | 2015-04-07 |