NPI | 1598963548 |
---|---|
Entity Type | Organization |
Authorized Contact | CLARENCE R BAKER President/CEO 757-338-7747 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 94002029) |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 94703001) |
Enumeration Date | 2007-07-10 |
Last Update Date | 2007-08-08 |