| NPI | 1366790107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN SCURLOCK INGRAM Chief Administrative Office 804-326-9046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1347-14-001) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: VA 1347-14-001) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |