| NPI | 1023452976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARITA RENE LEE Owner 757-289-0325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2019-02-12 |