NPI | 1053764340 |
---|---|
Entity Type | Organization |
Authorized Contact | YARDLEY WILSON BUTT President 757-237-3721 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1079) |
Enumeration Date | 2016-07-21 |
Last Update Date | 2016-07-21 |