| NPI | 1922793686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOINETTE NUMITAL THORNTON CEO 757-237-8460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-06-06 |