| NPI | 1942266515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE VERGARA CEO 757-388-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282E00000X (Licence: VA H-1858) |
| Additional Taxonomies | 282E00000X (Licence: VA H 1858) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2016-03-22 |