| NPI | 1093551624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIAUNA THORNE Owner 757-759-3889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |