| NPI | 1336222710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESHANA DENISE HENDERSON Associate Director 804-303-8393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 758-14-002) |
| Enumeration Date | 2006-10-22 |
| Last Update Date | 2020-08-22 |