| NPI | 1902097827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY A. CHARLES RN 757-220-4014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: VA ERO 2007-176) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2008-09-23 |