| NPI | 1497567960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELLE BELTON-MOORE Program Manager 757-685-8524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-01-22 |