| NPI | 1215102785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERMAN D SPRAGG CEO 804-515-8017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 88-259-46) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |