| NPI | 1710209150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE SMITH Owner 804-523-7702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA CO-435-10) |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2010-02-26 |