| NPI | 1598966913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN Z WEN Fiscal Services Manager 757-437-3475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 261-01-030) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: VA 261-01-030) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |