| NPI | 1376728949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LYNN DIXON Administrator 804-213-0140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 464-05-001) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 464-14-001) |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: VA 464-14-001) | |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2018-05-25 |