| NPI | 1780494906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIARA K GODWIN Owner 757-535-5506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-01-09 |
| Last Update Date | 2025-02-01 |