| NPI | 1669932612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISSY LAVONNE CROMWELL Owner 757-724-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2023-10-16 |