| NPI | 1629474044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRA BIRDEN Owner 757-383-3860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: VA 41409) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2014-11-12 |