| NPI | 1457505943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANNE SEARS Chief Administrations Officer 757-478-8814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2008-11-10 |