| NPI | 1316470081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONJA DENISE CARRAWAY CEO 757-567-3292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 2648) |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2017-04-09 |