| NPI | 1558808329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GIBSON Senior Clinical Manager 757-724-2256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2020-09-24 |