| NPI | 1912561713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEVITICUS LOFTON CEO 757-447-0102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2022-03-21 |