| NPI | 1922543743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ELIZABETH MELNYK Member 757-333-7523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2017-01-03 |