| NPI | 1770948648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEON EDMUND ZIMMERMANN Director Of Operations 434-835-2370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 907748) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2024-11-01 |