| NPI | 1215275672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN WELCH Co Owner 757-650-1154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1870-01-001) |
| Enumeration Date | 2013-01-19 |
| Last Update Date | 2013-01-19 |