| NPI | 1164978656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EPHAIM CRUZ President/CEO 757-227-1105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 2991) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2020-10-15 |