| NPI | 1790468387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASONE K HOSKINS Owner/Operator 757-748-2661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2023-08-09 |