| NPI | 1083704316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE W. HOFFLER Admionistrator 757-675-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 54) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2008-07-17 |