| NPI | 1275604589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEA COOK Office Manager 804-714-1812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 538-14-001) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-08-22 |