| NPI | 1366572372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEA COOK Office Manager 804-714-1812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: VA 53814003) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |