| NPI | 1912796772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATACHA WILLIAMS Biller/Credentialer 757-608-9255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2025-05-06 |