| NPI | 1851167191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANIQAH MCLEOD Owner 757-541-7199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-11-28 |
| Last Update Date | 2023-11-28 |