| NPI | 1184264756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE RICAFORTE Program Director 757-215-6953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251J00000X Nursing Care |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-01-13 |