| NPI | 1154149862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEDRICK MCCALL Clinical Director 804-564-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |