| NPI | 1447627179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LYNNE NASHETTE Executive Director 804-921-6359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA OLIS2235) |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2022-02-18 |