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 |