| NPI | 1750618039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HAWKES CAO 804-230-2337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: VA 1316-14-001) |
| Additional Taxonomies | 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities (Licence: VA 1316-14-001) |
| 385H00000X Respite Care (Licence: VA 1316-14-001) | |
| Enumeration Date | 2009-11-08 |
| Last Update Date | 2010-05-10 |