| NPI | 1093540676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMILLAH SHABAZZ President 804-362-8761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-09-04 |