| NPI | 1700266277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY BENNETT Administrator 434-430-0993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-05-31 |
| Last Update Date | 2015-05-31 |