| NPI | 1104986017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE EXNER Director 434-385-0262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 359) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2015-09-10 |