| NPI | 1659163715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON DAVIS COO 804-322-7795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X Community/Behavioral Health | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2025-05-22 |
| Last Update Date | 2025-05-22 |