| 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 |