| NPI | 1386838571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN OMONKHUALE MADOJEMU Program Director 757-393-0327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251C00000X |
| 251F00000X Home Infusion | |
| 251G00000X Hospice Care, Community Based | |
| 251J00000X Nursing Care | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 311Z00000X Custodial Care Facility | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 314000000X Skilled Nursing Facility | |
| 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2012-08-03 |