| NPI | 1720685191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA STEWARD Owner 804-460-9347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2022-11-02 |