| NPI | 1073748190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA PACITA GODDARD Owner 757-833-6291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |