| NPI | 1689601031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHELLE RUFUS COOPER Program Administrator 804-321-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 610-01-001) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-03-04 |