| NPI | 1710596051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKENDRA LLANOS Director 757-582-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-07-22 |