| NPI | 1205851110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LUCAS BURKE Assistant Executive Director 757-397-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 341-01-001) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-08-22 |