| NPI | 1558947531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY JEROME BLALOCK CEO 757-770-8214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2026-07-06 |