| NPI | 1376647552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA OROBIA CRUZ Residential Director 757-226-9037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VA 010288334) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 74501001) |
| 385H00000X Respite Care (Licence: VA 010288334) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-08-22 |