| NPI | 1033753264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKESHA D BROWN Owner 757-639-3948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2019-10-31 |