| NPI | 1790226215 |
|---|---|
| Former Legal Business Name | B&R SUPPORTIVE LIVING SERVICES |
| Entity Type | Organization |
| Authorized Contact | WYNTER WYNETTE RIDDICK Owner 757-367-1961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2022-11-28 |