| 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 |