| NPI | 1154760916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE DENISE COBB Certified Nursing Assistant 757-722-4504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: VA 1401009775) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2013-06-14 |