| NPI | 1699286039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN LORENZO MCDANIEL CEO 804-324-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2018-10-23 |