| NPI | 1124295795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES A. BAKER Administrative Director 804-233-6652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |