NPI | 1740601079 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMIE MELISSA TABB CEO/Owner 757-513-9195 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 2057) |
Enumeration Date | 2014-01-06 |
Last Update Date | 2014-01-06 |