| NPI | 1497322176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARVENNA REVELY Director 434-237-1575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2021-06-15 |