| NPI | 1487803227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAQUISA KATINA SIMMONS Chief Executive Officer 757-673-8117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2008-09-17 |