| NPI | 1013552611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALAYA FRALEY CEO 757-310-3063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2019-11-07 |