| NPI | 1114644309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATHOMAS HODGE Chief Executive Officer 757-849-3043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2023-01-27 |