| NPI | 1760917181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA PROSSER GRAHAM President 757-871-2477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-04-23 |
| Last Update Date | 2018-09-25 |