| NPI | 1902028251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA PINNOCK Owner 757-399-3025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 78214001) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |