| NPI | 1710445671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILTON RAWLES Owner 757-619-3276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2019-03-08 |