| NPI | 1104268507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE LITTLE Cota/L 757-319-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 0131000446) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2013-07-25 |