| NPI | 1952953424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA OLLIVIER PINNOCK Director 757-644-7025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |