| NPI | 1508000753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES FLOYD HARRIS Provider 804-795-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 1198-14-001) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |