| NPI | 1427824929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS TYRONE JOHNSON CEO 757-374-1741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-11-27 |