| NPI | 1073294229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN MILLER Owner 434-441-0427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-08-16 |