| NPI | 1609054261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA R HOLMES President / Owner 757-873-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: VA HCO- 08357) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: VA HCO-08357) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2009-06-18 |