| NPI | 1114066735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGER D WYATT Executive Director 804-553-0129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 735-01-001) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |