| NPI | 1922402510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LASSITER Executive/Clinical Director 757-228-5635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 2616) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2014-10-20 |