| NPI | 1013452317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE MCKIVER Executive Director 757-737-3611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 2352) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |