| NPI | 1376933051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHANDA POWELL Executive Director 804-520-0100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 927-02-001) |
| Additional Taxonomies | 251C00000X (Licence: VA 927-02-006) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |