| NPI | 1255509675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AISHA J BULLARD Manager 804-523-7702 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |