| NPI | 1578193090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES LOGAN Partner 434-334-0310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2020-01-23 |