| NPI | 1134383102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE MARIE BAILEY Administrator 804-475-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA CLO-08-1104074) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |