| NPI | 1083594741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS JEFFRIES Owner/Manager 804-908-3019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-09-04 |
| Last Update Date | 2025-09-04 |