| NPI | 1073322459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA S SAMUELS Owner 804-687-9427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2024-12-31 |
| Last Update Date | 2024-12-31 |