| NPI | 1134832611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMILLE L. BROWN Owner/Program Director 757-215-5794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2024-10-25 |