| NPI | 1417346503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTELIA TRIPLETT GRAY Owner 434-983-3884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 347C00000X Private Vehicle | |
| 251E00000X Home Health | |
| 253Z00000X In Home Supportive Care | |
| 302F00000X Exclusive Provider Organization | |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-27 |