| NPI | 1003382789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN NOWELL Executive Director 757-510-7044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2019-12-26 |