| NPI | 1356076863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYLA DIXON CEO 757-401-7047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2022-07-19 |