| NPI | 1699648576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMARIE BOGGS Owner 757-761-9190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2025-09-26 |
| Last Update Date | 2025-09-26 |