| NPI | 1104330695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY PRICE Administrative Coordinator 804-744-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1175-08-011) |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |