| NPI | 1285973297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLELIAN VICTORIA BOONE CEO/Owner 757-344-0839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 11L23566) |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2013-02-11 |