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, Mental Retardation and/or Developmental Disabilities (Licence: VA 85301001) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2008-06-24 |