| NPI | 1124262712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BELA SV AMIN Administrator 757-202-0825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1157) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |