| NPI | 1154210003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTAL B BROOKS Program Manager 757-822-3835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2025-07-02 |
| Last Update Date | 2025-07-02 |