| NPI | 1093632630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTICE PEEBLES Owner / Administrator 804-396-4010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-07-03 |
| Last Update Date | 2026-07-03 |