| NPI | 1912341926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANDA ANTRUM Chief Service Officer 757-227-6081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1823-02-006) |
| Enumeration Date | 2013-04-20 |
| Last Update Date | 2013-04-20 |