NPI | 1629515929 |
---|---|
Entity Type | Organization |
Authorized Contact | ADRIAN BROWN Qidp 757-739-0777 |
Organization Subpart ? | No |
Primary Taxonomy | 251E00000X Home Health |
Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 2585) |
Enumeration Date | 2017-01-24 |
Last Update Date | 2018-10-22 |