| NPI | 1073580163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREN LYNNE SEAGLE Executive Director 757-625-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 271-03-001) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: VA 271-02-006) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2020-08-22 |