| NPI | 1255041216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASHUNDA SHANIEL HOWARD Manager 757-532-6998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2022-11-30 |