| NPI | 1114737137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEONTE D OWENS CEO 804-324-8259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2025-01-11 |
| Last Update Date | 2025-01-11 |