| NPI | 1538538285 |
|---|---|
| Other Name | SUPPORTIVE IN-HOME SERVICES |
| Entity Type | Organization |
| Authorized Contact | LASHAUNDA REESE Chief Executive Officer 757-435-5297 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 2207) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |