| NPI | 1700131364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE HAWKINS Owner 757-380-0433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 1784) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2012-07-19 |