| NPI | 1508941105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE BURNETT Credentialing Specialist 434-455-5342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2017-04-12 |