| NPI | 1699910364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMALITA YVONNE KOVACH-WATTS Office Manager 757-499-5066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2008-12-11 |