| NPI | 1003509795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI ELTOM Director 804-691-6808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-05-30 |