| NPI | 1821490566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEON MICHAEL BRAXTON Owner 804-273-0579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: VA B09159000) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |