| NPI | 1750600953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENZO BROOKS CLEMONS President/CEO 757-301-1797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant |
| Additional Taxonomies | 385H00000X Respite Care (Licence: VA HCO-12624) |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities (Licence: VA HCO-12624) | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2011-10-28 |