| NPI | 1073673869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREL CALLIS Owner 804-833-2879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA SS18205) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |