| NPI | 1568790178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A JOHN BAMISILE CEO 804-745-8070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 1528-14-001) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 1528-14-002) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1528-14-001) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1528-14-002) | |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2009-11-20 |