| NPI | 1164443008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ZWADONY Finance Director 757-455-6126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: VA 18514001) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |