| NPI | 1144002411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL FRIAS Manager 804-218-7692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2023-10-23 |