| NPI | 1134969553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALITA HARRIS Owner 804-252-8087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2024-05-31 |