| NPI | 1750406815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIVA GATEWOOD President 804-550-1630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: VA DSS-268-05) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |