| NPI | 1356767040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA MICHELLE HOLLOWAY Director 757-348-0456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2014-03-05 |