| NPI | 1225610538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIDRA HARRIS Director Of Human Resources/Finance 757-512-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2021-10-05 |