| NPI | 1336318179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALILAH M SHABAZZ Chief Administrative Officer 757-622-1603 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2008-09-11 |