| NPI | 1790340354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA FOBBS Executive Director 804-712-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |