| NPI | 1013394089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIAN LEE FLOOD Owner 757-235-9390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 2310) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |