| NPI | 1104484856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXINE E LONG Chief Executive Officer 757-438-2340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |