| NPI | 1316433709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALESHA SMITH Director 757-553-6158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2024-03-14 |