| NPI | 1194154948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENNA EBRON President/Owner 757-706-3488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2013-11-02 |