| NPI | 1740753938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MURTADHA A SHAHEEN Manager 804-305-6849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 261QH0700X Clinic/Center, Hearing and Speech | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-01-10 |