| NPI | 1538258421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER G. FIDURA President 804-560-4640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 134) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-04 |