| NPI | 1093866691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH ANALISA MOODY Chief Executive Officer 757-692-2193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 85301001) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2008-06-24 |